Axillary recurrence after sentinel lymph node biopsy.
Sentinel lymph node biopsy (SLNB) without further axillary dissection in patients with sentinel node-negative breast carcinoma appears to be a safe procedure to ensure locoregional control. During a median follow-up of 35 months the false-negative rate was 1% in our study population of 185 patients.


BACKGROUND
The objective of this prospective study is to provide data on follow-up of patients with primary operable breast carcinoma staged with SLNB without axillary lymph node dissection (ALND) if the sentinel lymph nodes (SLNs) were tumour-negative.


METHODS
One hundred and eighty-five patients were enrolled. Preoperative dynamic and static lymphoscintigraphy were performed; both a vital blue dye and a gamma detection probe were used intraoperatively. Patients with tumour-positive SLNs received completion ALND or if no SLNs could be identified. All patients were monitored according to regional follow-up protocols.


RESULTS
The SLNs were identified in 179 out of the 185 patients. In 73 patients the SLNs were tumour-positive and in 106 patients tumour-negative. The median follow-up was 35 months (range 17-59). In one SLN-negative patient an axillary recurrence occurred 26 months after the SLNB (false-negative rate: 1%).


CONCLUSIONS
SLNB without ALND appears to be a safe procedure to ensure locoregional control in SLN-negative breast carcinoma, if carried out by an experienced team.
Department of Surgical Oncology, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
B
B
van der Vegt
M H E
MH
Doting
P L
PL
Jager
J
J
Wesseling
J
J
de Vries
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology / Q000473:pathology; D018275:Carcinoma, Lobular / Q000453:epidemiology / Q000473:pathology; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology*; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy / Q000592:standards*