Is Axillary Lymphadenectomy Necessary in Triple Negative Breast Cancer Patients Treated with Subcutaneous Mastectomy with The Immediate Reconstruction?

The aim of our study was to compare treatment outcomes of patients with Triple Negative Breast Cancer (TNBC) treated with or without a Sentinel Lymph Node Biopsy (SLNB) and with nipple sparing or skin sparing subcutaneous mastectomy with the immediate Breast Reconstruction (IBR) with a prosthesis. A total of 114 consecutive patients with TNBC were enrolled in this study treated at the Holycross Cancer Centre in Kielce, Poland between 2013 and 2020. Apart from the systemic treatment and radiotherapy, in all patients, subcutaneous mastectomy was performed. The sentinel lymph node biopsy procedure was applied in 82 patients. The restricted mean survival for non-SLNB and SLNB patients was 84.6 months and 101.9 months, respectively. A significant association of the life status was found for the clinical stage, a sentinel node biopsy procedure application, radiotherapy, complete pathological regression after neoadjuvant chemotherapy, and cancer progression. Based on the Monte Carlo simulation, it was found that without taking Clinical Stage (CS) into consideration, the distribution of possible deaths in non-SLNB patients was 99% more likely than in SLNB patients. In CS II, CS III, and CS II and III together, death rate in non-SLNB patients was 85%, 78%, and 97%, respectively and more likely than in SLNB patients.