{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:19:20Z","timestamp":1760145560744,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The management of the axilla in breast cancer patients with isolated chest wall recurrence (CWR) after mastectomy remains controversial. Although sentinel lymph node biopsy (SLNB) for restaging is feasible, its role is unclear. We aimed to determine if the omission of axillary restaging surgery in female patients with operable presumably isolated CWRs could result in an increased risk of second recurrences. Methods: In this retrospective multicentre study, patients who developed CWRs were reviewed. We excluded patients with suspected or concomitant regional\/distant metastases, bilateral cancers and patients without CWR surgery. Patients\u2019 demographics, pathological data and subsequent recurrences were collected from a prospective database and were compared between patients with axillary lymph node dissection (ALND) and\/or SLNB versus no axillary operation at CWR. Findings: A total of 194 patients with CWRs were eligible. The median age at CWR was 56.0 (IQR 47.0\u201367.0) years old. At recurrence, 8 (4.1%), 5 (2.6%) and 181 (93.3%) patients had ALND, SLNB and no axillary operation, respectively. Patients with no axillary surgery during CWR were associated with, at primary cancer, a lower incidence of ductal carcinoma in situ as diagnosis (p = 0.007) and older age (p = 0.022). Subsequent ipsilateral axillary (p = 0.768) and second recurrences (p = 0.061) were not statistically different between patients with and without axillary surgery at CWR on median follow-up of 59.5 (IQR 27.3\u2013105) months. Interpretation: In patients without evidence of concomitant regional or distant metastasis at CWR diagnosis, omission of axillary restaging surgery was not associated with an increased ipsilateral axillary or second recurrences on long-term follow-up.<\/jats:p>","DOI":"10.3390\/cancers16152699","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T16:37:17Z","timestamp":1722271037000},"page":"2699","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Oncologic Outcomes of Omitting Axillary Surgery in Breast Cancer Patients with Chest Wall Recurrence after Mastectomy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5296-3437","authenticated-orcid":false,"given":"Geok Hoon","family":"Lim","sequence":"first","affiliation":[{"name":"Breast Department, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"},{"name":"Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore"},{"name":"SingHealth Duke-NUS Breast Centre, Singapore 168582, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1514-6841","authenticated-orcid":false,"given":"Veronica Siton","family":"Alcantara","sequence":"additional","affiliation":[{"name":"Breast Department, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"},{"name":"SingHealth Duke-NUS Breast Centre, Singapore 168582, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"John Carson","family":"Allen","sequence":"additional","affiliation":[{"name":"Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6473-4375","authenticated-orcid":false,"given":"Seyed Ehsan","family":"Saffari","sequence":"additional","affiliation":[{"name":"Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronique Kiak Mien","family":"Tan","sequence":"additional","affiliation":[{"name":"SingHealth Duke-NUS Breast Centre, Singapore 168582, Singapore"},{"name":"Department of Breast Surgery, Singapore General Hospital, Singapore 544886, Singapore"},{"name":"Division of Surgery and Surgical Oncology, National Cancer Centre, Singapore 168583, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8573-4606","authenticated-orcid":false,"given":"Kiat Tee Benita","family":"Tan","sequence":"additional","affiliation":[{"name":"SingHealth Duke-NUS Breast Centre, Singapore 168582, Singapore"},{"name":"Department of Breast Surgery, Singapore General Hospital, Singapore 544886, Singapore"},{"name":"Division of Surgery and Surgical Oncology, National Cancer Centre, Singapore 168583, Singapore"},{"name":"Breast Service, Department of Surgery, Sengkang General Hospital, Singapore 544886, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4319-3389","authenticated-orcid":false,"given":"Sabrina","family":"Ngaserin","sequence":"additional","affiliation":[{"name":"SingHealth Duke-NUS Breast Centre, Singapore 168582, Singapore"},{"name":"Breast Service, Department of Surgery, Sengkang General Hospital, Singapore 544886, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Ming","family":"Tan","sequence":"additional","affiliation":[{"name":"SingHealth Duke-NUS Breast Centre, Singapore 168582, Singapore"},{"name":"Division of Breast Surgery, Changi General Hospital, Singapore 529889, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lester Chee Hao","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Singapore General Hospital, Singapore 169608, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuh Yong","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, National Cancer Centre, Singapore 168583, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ho, P.J., Yeoh, Y.S., Miao, H., Lim, S.H., Tan, E.Y., Tan, B.K.T., Tan, V.K.M., Tan, S.M., Yong, W.S., and Wong, F.Y. 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