{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:45:57Z","timestamp":1761518757786,"version":"build-2065373602"},"reference-count":49,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T00:00:00Z","timestamp":1097193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2004,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The role of axillary lymph node dissection (AxD) for patients with breast carcinoma who have clinically negative lymph nodes (cN0) and undergo breast\u2010conserving therapy has been controversial. If patients do not undergo AxD, then it is uncertain whether specific lymph node irradiation should be given. The authors compared the results obtained from patients w ho underwent AxD with the results from patients who received axillary irradiation (AxR) using one of two radiotherapy techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients with T1\u2013T2cN0 breast carcinoma were treated from 1983 to 2002 with either AxD (80 patients) or AxR (1134 patients received tangential\u2010field [2\u2010field] irradiation, and 303 patients received 3\u2010field irradiation). The median follow\u2010up was 161 months for the AxD group and 66 months for the AxR group (55 months for patients who received tangential\u2010field irradiation, and 122 months for patients who received 3\u2010field irradiation).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>One patient in the AxD group and 35 patients in the AxR group had axillary recurrences. The 10\u2010year cumulative axillary recurrence rates were 1.3% and 4.6% for the AxD group and the AxR group, respectively (<jats:italic>P<\/jats:italic> = 0.21). For patients with T1 tumors, the 10\u2010year overall survival rates for the two groups were 94.7% and 92.7%, respectively (<jats:italic>P<\/jats:italic> = 0.34); and, for patients with T2 tumors, the 10\u2010year overall survival rates were 92.5% and 89.1%, respectively (<jats:italic>P<\/jats:italic> = 0.34). In the AxR group, the 5\u2010year axillary recurrence rates were 2.5% for patients who received tangential\u2010field irradiation and 1.7% for patients who received 3\u2010field irradiation (<jats:italic>P<\/jats:italic> = 0.18), and the 5\u2010year regional recurrence rates for the two groups were 4.8% and 2.4%, respectively (<jats:italic>P<\/jats:italic> = 0.048). On multivariate analysis, positive lymphovascular invasion, outer tumor location, and larger tumor size were significant risk factors for regional failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>For patients with cN0 breast carcinoma, AxD and AxR yielded the same overall survival rates. Most patients can be treated safely with tangential\u2010field irradiation alone. Patients who are at increased risk of regional failure may benefit from three\u2010field irradiation. Cancer 2004. \u00a9 2004 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.20650","type":"journal-article","created":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T13:02:25Z","timestamp":1097240545000},"page":"2155-2163","source":"Crossref","is-referenced-by-count":13,"title":["Treatment of breast carcinoma in patients with clinically negative axillary lymph nodes using radiotherapy versus axillary dissection"],"prefix":"10.1002","volume":"101","author":[{"given":"Naoko","family":"Fujimoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Amemiya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuya","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoyuki","family":"Shigematsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,10,8]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198503143121102"},{"key":"e_1_2_5_3_2","first-page":"251","article-title":"Is axillary lymph node dissection necessary in routine management of breast cancer? 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