Significance of Axillary Lymph Node Extranodal Soft Tissue Extension and Indications for Postmastectomy Irradiation
John E. Mignano, Marianna L. Zahurak, Anuradha Chakravarthy, et. al.
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001
Reviewers: Li Liu, MD
Source: Cancer, 86(7): 1258-1262, October 1999.
BackgroundExtranodal soft tissue extension (ETE) is associated with decreased survival and increased recurrence rates in patients with breast cancer. However, whether axillary irradiation would improve local control remains uncertain. This study reports on a series of patients assessed for ETE status.
MethodsMignano and associates reported the outcomes for 487 patients who underwent mastectomy and axillary lymph node dissection for infiltrating (T1-T3) breast carcinoma and did not receive postoperative irradiation. All patients had pathologically confirmed axillary lymph node metastases and negative surgical margins.
- The risk of axillary lymph node recurrence in ETE positive patients was low, even without axillary lymph node irradiation.
- Patients with ETE were at increased risk for chest wall recurrence and/or distant failure.
- Chest wall recurrences were more common than axillary recurrences in patients with ETE.