Minimally invasive axillary lymph node dissection versus conventional axillary lymph node dissection: a comparative study on short-term efficacy in breast cancer.

BACKGROUND

This study aims to compare the short-term clinical efficacy of minimally invasive axillary lymph node dissection (MIAD) versus conventional axillary lymph node dissection (CAD) in the treatment of breast cancer with positive axillary lymph nodes.

METHODS

We performed a retrospective analysis of the clinical data of breast cancer patients who underwent MIAD and CAD in the Breast Surgery Department from January 2022 to August 2024. The primary outcomes assessed included surgical results, complications, post-operative upper limb function, and quality of life score for both groups.

RESULTS

This study enrolled 147 patients, with 71 undergoing MIAD (including 25 with endoscopic-assisted axillary lymph node dissection and 46 with robotic-assisted axillary lymph node dissection) and 76 undergoing CAD. Compared to CAD, the mean intraoperative blood loss in the MIAD was lower (5.63 ± 4.16 vs. 21.13 ± 6.81 ml, p < 0.001). Impressively, in patients with BMI ≥ 24 kg/m2, there was no statistical difference in operative time between the two groups. Furthermore, despite an overall increase of 9.39 min in surgical duration in MIAD (47.52 ± 8.95 vs. 39.09 ± 9.20 min, p < 0.001), its advantages include lower degree of post-operative pain, better post-operative shoulder joint range of motion, and DSAH and FACT-B + 4 score (112.90 ± 10.80 vs. 106.88 ± 11.11, p = 0.001). There was no statistically significant difference in the post-operative complications and initial oncological outcomes between the two groups.

CONCLUSIONS

MIAD is a safe alternative to CAD, particularly for obese patients. It significantly reduces intraoperative blood loss while improving post-operative shoulder joint function and enhancing quality of life.