From Axillary Lymph Node Dissection to Sentinel Node Biopsy in Breast Cancer: A 23-Year Population-Based Large-Sample Study with Long-Term Survival Outcomes.
[PURPOSE] Axillary surgery in breast cancer has progressively evolved over the past decades toward less invasive approaches.
APA
Mangone L, Marinelli F, et al. (2026). From Axillary Lymph Node Dissection to Sentinel Node Biopsy in Breast Cancer: A 23-Year Population-Based Large-Sample Study with Long-Term Survival Outcomes.. Breast cancer (Dove Medical Press), 18, 573154. https://doi.org/10.2147/BCTT.S573154
MLA
Mangone L, et al.. "From Axillary Lymph Node Dissection to Sentinel Node Biopsy in Breast Cancer: A 23-Year Population-Based Large-Sample Study with Long-Term Survival Outcomes.." Breast cancer (Dove Medical Press), vol. 18, 2026, pp. 573154.
PMID
42022883
Abstract
[PURPOSE] Axillary surgery in breast cancer has progressively evolved over the past decades toward less invasive approaches.
[PATIENTS AND METHODS] This population-based study analyzed 10,955 women diagnosed with invasive breast cancer between 2000 and 2022 in Reggio Emilia, Italy, to assess long-term trends in axillary management.
[RESULTS] A marked decline in axillary lymph node dissection (ALND) was observed-from 47.9% in 2000-2004 to 18.1% in 2017-2022-with a parallel increase in sentinel lymph node biopsy (SLNB) from 43.8% to 74.7%. The shift was particularly pronounced in stage I tumors, where ALND dropped from 44.7% to 2.9%. Overall survival at 15 years was significantly higher in the SLNB group (78%) compared to the ALND group (72%). These results align with major clinical trials (e.g. ACOSOG Z0011, SINODAR-ONE), confirming their applicability in unselected populations. Although ALND remained more frequent in patients with larger tumors or undergoing mastectomy, its role has substantially diminished.
[CONCLUSION] Our findings reinforce the safety and effectiveness of conservative axillary approaches and reflect their successful implementation in real-world practice. Further research should address the impact of these trends on quality of life and incorporate additional data on radiotherapy and tumor biology to guide future surgical decision-making.
[PATIENTS AND METHODS] This population-based study analyzed 10,955 women diagnosed with invasive breast cancer between 2000 and 2022 in Reggio Emilia, Italy, to assess long-term trends in axillary management.
[RESULTS] A marked decline in axillary lymph node dissection (ALND) was observed-from 47.9% in 2000-2004 to 18.1% in 2017-2022-with a parallel increase in sentinel lymph node biopsy (SLNB) from 43.8% to 74.7%. The shift was particularly pronounced in stage I tumors, where ALND dropped from 44.7% to 2.9%. Overall survival at 15 years was significantly higher in the SLNB group (78%) compared to the ALND group (72%). These results align with major clinical trials (e.g. ACOSOG Z0011, SINODAR-ONE), confirming their applicability in unselected populations. Although ALND remained more frequent in patients with larger tumors or undergoing mastectomy, its role has substantially diminished.
[CONCLUSION] Our findings reinforce the safety and effectiveness of conservative axillary approaches and reflect their successful implementation in real-world practice. Further research should address the impact of these trends on quality of life and incorporate additional data on radiotherapy and tumor biology to guide future surgical decision-making.
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