[Negative sentinel node in breast cancer patients a good indicator for continued absence of axillary metastases].
OBJECTIVE
To determine the prevalence of axillary recurrences in sentinel-node-negative patients with breast cancer who had no axillary dissection.


METHODS
Follow-up study.


METHODS
The first one hundred consecutive sentinel-node-negative patients with a minimal follow-up of 36 months (median 47) were included in this study. All patients underwent sentinel-node biopsy using the triple technique. During the first year after the operation patients were seen on a 3-monthly basis and thereafter every 6 months.


RESULTS
Intensive pathological examination of the harvested sentinel nodes revealed no (micro)metastases in any patient. One patient developed an axillary recurrence after 24 months. Three out of the 100 patients developed distant metastases during follow-up; 2 of them died as a result of these metastases. One patient was treated for a local mammary recurrence. In terms of survival the sentinel-node procedure did not appear to be disadvantageous: the 3-year survival rate in our study was 98% for node-negative patients, compared to 88-94% quoted in the literature for node-negative patients after axillary dissection. This apparent improvement may be due to better staging of breast-cancer patients through the use of the sentinel-node procedure (stage migration).


CONCLUSIONS
The triple technique was a reliable method for identifying the sentinel node in breast-cancer patients. Compared to the historical data on node-negative breast cancer, the sentinel-node procedure improved the prognosis of node-negative breast-cancer patients. This effect was probably due to the more accurate staging of breast-cancer patients using the sentinel-node procedure.
Meijer
S
S
VU Medisch Centrum, afd. Chirurgische Oncologie, De Boelelaan 1117, 1081 HV Amsterdam. s.meijer@vumc.nl
Torrenga
H
H
van der Sijp
J R M
JR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D016019:Survival Analysis
Negatieve schildwachtklier bij borstkankerpatiënten goede indicator voor het uitblijven van okselmetastasen.