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Invited Critique
Sep 2011

When More Is Too Much: Axillary Node Dissection in the Sentinel Node EraComment on “Unnecessary Axillary Surgery for Patients With Node-Negative Breast Cancer Undergoing Total Mastectomy”

Author Affiliations

Author Affiliation: Division of Surgical Oncology, Department of Surgery, East Carolina University, Greensville, North Carolina.

Arch Surg. 2011;146(9):1033-1034. doi:10.1001/archsurg.2011.192

In their study on the use of axillary node dissection in the era of sentinel node staging, Olaya et al1 determine the extent of sentinel node staging in California among women with small primary tumors or ductal carcinoma in situ who underwent mastectomy. Their results demonstrate that significant numbers of women undergoing total mastectomy who would be considered appropriate candidates for sentinel node staging are instead undergoing complete axillary node dissection without prior sentinel node biopsy. These women tend to be older, have larger tumors, be of lower SES or Hispanic or Asian/Pacific Islander heritage, and be treated in hospitals without cancer programs that have been approved by American College of Surgeons.

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