AB032. SOH25_AB_113. Surgical and radiotherapy patterns of care and 5-year outcomes of positive sentinel lymph nodes in University Hospital Limerick
Clinical Breast

AB032. SOH25_AB_113. Surgical and radiotherapy patterns of care and 5-year outcomes of positive sentinel lymph nodes in University Hospital Limerick

Sarah Elmedany1, Sheelagh Stephens2, Nichola McNamara1, Juliette Buckley1, Chwanrow Baban1, Shona Tormey1, Lorraine Walsh2, Anne Merrigan1

1Symptomatic Breast Unit, University Hospital Limerick, Dooradoyle, Limerick, Ireland; 2Mid-Western Radiation Oncology Department, University Hospital Limerick, Dooradoyle, Limerick, Ireland

Background: Axillary disease management in breast cancer has evolved significantly over the past 30 years. The pivotal Z0011 trial (2010) demonstrated that 10-year overall survival for patients with early-stage invasive breast cancer, without palpable axillary adenopathy and 1–2 metastatic sentinel lymph nodes, was non-inferior with sentinel lymph node dissection alone compared to axillary lymph node dissection, when patients received high tangent breast radiotherapy. We aim to compare axillary management practices at University Hospital Limerick with the Z0011 approach and evaluate 5-year disease outcomes and survival rates across different strategies.

Methods: A retrospective analysis of patients with positive sentinel lymph nodes from 2014 to 2018 was conducted using a prospectively maintained database. Data on axillary clearance and high tangent radiotherapy were reviewed (including level 1 axilla). Five-year outcomes, including local recurrence, distal metastasis, and mortality, were analysed across treatment modalities.

Results: Of 999 patients, 129 with positive sentinel nodes were identified (age range 30–83 years). Among 42 patients treated with high tangent breast radiotherapy alone, 5-year mortality was 16.7%, local recurrence 2.4%, and distal metastasis 14.3%. For 15 patients treated with axillary clearance without high tangent radiotherapy, 5-year mortality was 26.7%, local recurrence 13.3%, and distal metastasis 20.0%. Any differences between treatment groups were not statistically significant.

Conclusions: Management of early-stage breast cancer with positive sentinel nodes is advancing. Local data suggest high tangent radiotherapy yields non-inferior 5-year outcomes when compared with axillary clearance. Multidisciplinary discussions remain critical to optimising individualised care.

Keywords: Axillary node clearance; breast cancer; radiotherapy; sentinel-node-positive; 5-year outcomes

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab032
Cite this abstract as: Elmedany S, Stephens S, McNamara N, Buckley J, Baban C, Tormey S, Walsh L, Merrigan A. AB032. SOH25_AB_113. Surgical and radiotherapy patterns of care and 5-year outcomes of positive sentinel lymph nodes in University Hospital Limerick. Mesentery Peritoneum 2025;9:AB032.

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