{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:52:49Z","timestamp":1778158369798,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>The ACOSOGZ0011 trial found that overall survival (OS) for patients with 1\u20132 positive nodes undergoing sentinel lymph node biopsy\u2010alone (SLNB) was noninferior to completion axillary lymph node dissection (ALND), but excluded patients undergoing mastectomy. Our study examined patterns of ALND and its relationship with OS for SLNB\u2010positive patients undergoing mastectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Cancer Database was queried (2010\u20132017) for patients with cT1\u20102N0 breast cancer undergoing mastectomy with positive sentinel lymph nodes. Clinical data were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 20\u2009001 patients, 11\u2009574 (57.9%) underwent SLNB\u2009+\u2009ALND, and 8427 (42.1%) had SLNB\u2010alone. The SLNB\u2009+\u2009ALND group had more positive nodes (mean 2.6 vs. 1.3, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and more frequently received nodal radiation (33.4% vs. 28.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Patients diagnosed in later years were less likely to undergo ALND (2010: reference; 2017:\u00a0odds ratio: 0.29, 95% confidence interval [CI]:\u00a00.25\u20130.33, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). ALND (hazard ratio [HR]: 0.97, 95%\u00a0CI: 0.89\u20131.06, <jats:italic>p<\/jats:italic>\u2009=\u20090.49) and nodal radiation (HR: 0.92, 95%\u00a0CI: 0.83\u20131.02, <jats:italic>p<\/jats:italic>\u2009=\u20091.06) were not independently associated with OS. Propensity\u2010score matched 5\u2010year OS was similar (SLNB\u2009+\u2009ALND: 90.9% vs.\u00a0SLNB\u2010alone: 90.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.65).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For patients undergoing mastectomy for cT1\u20102N0 breast cancer with positive SLNB, SLNB\u2010alone was common and increased over time. Axillary radiation was not routinely delivered in the SLNB\u2010alone group. Completion ALND and nodal radiation were not associated with improved survival.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27503","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T10:18:36Z","timestamp":1699870716000},"page":"468-480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Patterns of completion axillary dissection for patients with cT1\u20102N0 breast cancer undergoing total mastectomy with positive sentinel lymph nodes"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0595-6434","authenticated-orcid":false,"given":"Lara","family":"Schwieger","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren M.","family":"Postlewait","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Emory University School of Medicine Atlanta Georgia USA"},{"name":"Glenn Family Breast Center Emory University Atlanta Georgia USA"},{"name":"Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute Emory University Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preeti D.","family":"Subhedar","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Emory University School of Medicine Atlanta Georgia USA"},{"name":"Glenn Family Breast Center Emory University Atlanta Georgia USA"},{"name":"Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute Emory University Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feifei","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute Emory University Atlanta Georgia USA"},{"name":"Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Emory University School of Medicine Atlanta Georgia USA"},{"name":"Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute Emory University Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8673-3349","authenticated-orcid":false,"given":"Cletus A.","family":"Arciero","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Emory University School of Medicine Atlanta Georgia USA"},{"name":"Glenn Family Breast Center Emory University Atlanta Georgia USA"},{"name":"Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute Emory University Atlanta Georgia 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