title: Preliminary outcome analysis in patients with breast cancer and a positive sentinel lymph node who declined axillary dissection.
abstract: BACKGROUND
  This retrospective study was designed to provide a preliminary outcome analysis in patients with positive sentinel nodes who declined axillary dissection.
  
  
  METHODS
  A review was conducted of patients who underwent lumpectomy and sentinel lymph node excision for invasive disease between January 1998 and July 2000. Those who were found to have sentinel lymph node metastasis without completion axillary dissection were selected for evaluation. Follow-up included physical examination and mammography.
  
  
  RESULTS
  Thirty-one patients were identified who met inclusion criteria. Primary invasive cell types included infiltrating ductal carcinoma, infiltrating lobular carcinoma, and mixed cellularity. Most primary tumors were T1. Nodal metastases were identified by hematoxylin and eosin stain and immunohistochemistry. Twenty-seven of the metastases were microscopic (<2 mm), and the remaining four were macroscopic. All patients received adjuvant systemic therapy. With a mean follow-up of 30 months, there have been no patients with axillary recurrence on physical examination or mammographic evaluation.
  
  
  CONCLUSIONS
  We have presented patients with sentinel lymph nodes involved by cancer who did not undergo further axillary resection and remain free of disease at least 1 year later. This preliminary analysis supports the inclusion of patients with subclinical axillary disease in trials that randomize to observation alone.
authors.affiliation: Department of Surgery, Baylor University Medical Center, Dallas, Texas, USA.
authors.forename: Jerri S
authors.initials: JS
authors.lastname: Fant
authors.forename: Michael D
authors.initials: MD
authors.lastname: Grant
authors.forename: Sally M
authors.initials: SM
authors.lastname: Knox
authors.forename: Sheryl A
authors.initials: SA
authors.lastname: Livingston
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ridl
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Jones
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Kuhn
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local; D010808:Physical Examination; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome