Is There a Difference in Nodal Yield when Comparing Primary and Completion Clearance of the Axilla in the Treatment of Primary Breast Cancer?

Background: In the treatment of breast cancer, axillary nodal status is one of the most important prognostic factors and is therefore a guide to adjuvant treatment. Primary axillary lymph node dissection (pALND) is the treatment of choice in case of a clinically positive axillary node, while completion axillary node dissection (cALND) may be performed in case of an unforeseen positive sentinel node. Although pALND and cALND are technically comparable, cALND may be more challenging because of local changes due to the performed sentinel node procedure (SNP), possibly leading to differences in nodal yields. In this study, we examined the nodal yield of pALND and cALND in breast cancer patients and analyzed the effect of age and neo-adjuvant chemotherapy (NAC) on yields of both total and positive nodes.