Background: This study aimed to assess the overall survival and disease-free survival after axillary lymph node dissection (ALND) and whole breast radiotherapy (WBRT).
Methods: This was a prospective cohort study. Twenty female patients with enlarged ALN metastasis of breast origin with occult primary tumor not detected by MRI were recruited for ALND and WBRT with or without neoadjuvant chemotherapy.
Results: Twenty of 1823 patients (1%) were diagnosed with axillary metastasis of breast origin with occult primary breast carcinoma (OBC) not detected by MRI. Sixteen patients (80%) have N1 disease, sixteen (80%) were estrogen receptorâ?"positive, four (20%) were HERII-positive and two (10%) were triple negative. Eighteen patients (90%) underwent ALND with WBRT and two (10%) underwent sentinel lymph node biopsy with WBRT. Five patients (25%) received neoadjuvant chemotherapy and two of them (40%) gave complete pathological response. No local recurrence in the follow-up period was detected. All patients will be followed after 3 years and 5 years as regard disease free survival & overall survival.
Conclusions: Due to limited experience in OBC, the optimal treatment is not yet established. There was no difference between modified radical mastectomy and ALND with WBRT as regard overall survival and disease-free survival.
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