Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Oncology (Surgical)

A certain number of patients have extra-capsular invasion (ECI) at the sentinel lymph node (SLN), but only a few report described its clinical significance (Shigematsu et al.,2015). Axillary lymph node dissection (ALND) had been the standard of care in the management of operable breast cancer for local disease control and precise axillary staging. However, ALND is associated with unfavorable complications including arm pain, numbness and lymphedema (Sanghani et al,2009). To avoid the comorbidity of ALND, sentinel lymph node (SLN) biopsy was developed for patients with clinically node-negative operable breast cancer, because large clinical trials have shown that SLN biopsy gives an equivalent prognosis and less arm morbidity than ALND for SLN- negative patients (Krag et al., 2010). ALND is strongly discouraged for SLN-negative patients, but has remained a standard procedure for SLN-positive patients because approximately 40% of them were estimated to have non-SLN metastasis (Werkoff et al.,2009) .However, in a recent prospective randomized study, omitting ALND did not affect local control or prognosis for SLN-positive patients (Giuliano et al.,2011). So, our study is a retrospective study from January 2013 to December 2015 involving patients with breast cancer that have underwent SLN mapping, revealed SLN positive and underwent ALND. ECI at SLN positive was studied and divided the patients into two groups according to presence or absence of ECI

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