Background: For patients with breast cancer, axillary dissection

was a standard treatment, especially with patient
with positive metastases in the sentinel nodes. For some
patients axillary dissection might be over-treatment, including
those who have had a mastectomy. Especially with
the new trend of many radiation-therapy centers, provide
radiation-therapy for any number of positive lymph nodes.
The aim of our work is to evaluate the impact of number of
dissected axillary Lymph Nodes (LN), on Overall Survival
(OS) and Progression Free Survival (PFS) in breast cancer
patients.
Methods: This is a retrospective study done in Sohag
University hospitals between periods 1/2008 till 12/2014.
One hundred and three patients diagnosed with breast
cancer were reviewed regarding number of axillary lymph
nodes dissected in correlation to progression free survival,
overall survival. We divided the patients into two groups
according to number of dissected lymph nodes more than
10 LNs (73 patients or less than ten LN (30 patients)). The
patients were categorized into N0 (No LN positive), N1 (1-3
LN positive), N2 (3-9LN positive) in both groups, and N3 in
first group only as it is more than 10 LN positive.
Results: Median PFS for patients having more than 10
LN excised was for N0, N1, N2, N3 5.19, 4.77, 4.14, 3.69
years respectively ,while in the group with less than 10 LN
excised PFS was 4.5, 4.14, 4.08 years respectively with no
significant difference between both groups P = 0.290. As
regard median OS for patients having more than 10 LN
excised was for N0, N1, N2, N3 5.57, 5.94, 4.97, 4.61 years
respectively while in the other group having less than 10 LN
excised OS was 5.4, 5.14, 5.14 years respectively with P =
0.117. Regarding Lymphedema There was highly significant
difference between both arms p value 0.000, with higher
grades in arm I (moderate 17 cases and 6 cases severe
edema).
Conclusions: We found no significant OS or PFS differences
with higher LN dissection compared with less LN dissection,
but this needs further prospective studies. Quality of
life was better for the less axillary dissected patients due to
significantly lower incidence of advanced grade lymphedema.