Inequality in sentinel lymph node dissection for elderly women with early stage breast cancer: Results from a French prospective cohort study

ObjectiveTo identify factors associated with under-use of sentinel lymph node dissection (SLND).Materials and MethodsThis study was performed in ELIPPSE 65, a representative cohort of women aged ≥ 65 with breast cancer. We included all women eligible for SLND. Characteristics of those who had received SLND – whether or not axillary lymph node dissection (ALND) was subsequently carried out – were compared with those having received immediate ALND without prior SLND.ResultsA total of 349 women were eligible for SLND. After excluding those without surgery or with unknown axillary surgery type, 337 women were analyzed. Immediate ALND was performed in 20% of cases. Immediate ALND had been performed more frequently in women aged ≥ 75 and in those who had poor family support.ConclusionAlthough SLND is a widespread surgical practice, many women still have unnecessary ALND. This is particularly detrimental for elderly women as their life may be strongly impaired by lymphedema.