Audit of Preoperative Axillary Staging and Axillary Recurrence in Early Invasive Breast Cancer at a Single Centre.
Foss, H Kiruparan, N Will, S Voynov, V Patel, C Bharnala, G
Foss, H
Kiruparan, N
Will, S
Voynov, V
Patel, C
Bharnala, G
Affiliation
The Dudley Group NHS Foundation Trust
Other Contributors
Publication date
2025/06/10
Subject
Collections
Research Projects
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Journal Issue
Abstract
This study aimed to assess our hospital's compliance with the Association of Breast Surgery guidelines for axillary management in early breast cancer. The guidelines recommend preoperative axillary ultrasound for invasive breast cancer, with ultrasound-guided biopsy for suspicious findings. Sentinel lymph node biopsy (SLNB) is the preferred staging procedure, and axillary node clearance (ANC) is advised for confirmed axillary node metastasis. Effective staging should ensure axillary recurrence rates remain below 5% at 5 years. Data was collected for patients undergoing axillary procedures between October 2017 and October 2018. Inclusion criteria were invasive breast cancer or ductal carcinoma in situ (DCIS) with mastectomy. Exclusions included prior breast cancer or axillary procedures for non-breast cancer reasons. Key data included preoperative imaging, biopsy findings, surgical interventions, and 5-year outcomes. Among 235 patients (mean age 61), 61.7% had invasive cancer, 37% had DCIS, and 1.3% had both invasive cancer and DCIS. SLNB was performed in 203 patients, ANC in 26, and axillary sampling in 2. All patients with ultrasound findings of U3 or higher underwent ultrasound-guided biopsy. Of 26 patients with suspicious (B4) biopsies, 25 underwent ANC, while 1 underwent SLNB with no recurrence at 5 years. Axillary recurrence occurred in 3 patients (1.27%), two of whom experienced local recurrence first. Our data show high compliance with staging guidelines and a low axillary recurrence rate of 1.27%, well below the 5% benchmark at 5 years, supporting the effectiveness of current practice.
Citation
H Foss, N Kiruparan, S Will, V Voynov, C Patel, G Bharnala, 189 Audit of Preoperative Axillary Staging and Axillary Recurrence in Early Invasive Breast Cancer at a Single Centre,�BJS, Volume 112, Issue Supplement_10, June 2025, znaf128.324,�https://doi.org/10.1093/bjs/znaf128.324