Surgical management of the positive sentinel lymph node in elderly breast cancer patients

Abstract

872 Background: Standard practice is to perform a completion axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel lymph nodes (SLNs). However, among patients with a negative intraoperative frozen section (FS) who prove SLN-positive on final pathologic examination, the risk of non-SLN metastases is small. Here we examine whether patient age (P=0.036) and breast-conserving surgery was more frequent (66% vs. 57%, P=0.015) in the older group. Among those 70 or older, moderate or severe comorbidity was present in 61%, but (compared with those with minimal or no comorbidity) did not affect the type of breast operation or the performance of completion ALND. Completion ALND was done less often in the older patients (P <0.0001). Conclusions: Compared with women <70 years old, older women were less likely to have a completion ALND after a positive SLN biopsy, but comorbidity did not appear to affect treatment decisions. No significant financial relationships to disclose.