Axillary ultrasonography to detect recurrence after sentinel node biopsy in breast cancer.
BACKGROUND
Sentinel node biopsy (SNB) for breast cancer has a false-negative rate of approximately 5%. Initial reports of follow-up show lower axillary recurrence rates than expected. We performed axillary ultrasonography to determine whether occult recurrences could be detected.


METHODS
In a community hospital setting, 289 patients who had SNB for breast cancer in a single surgeon's practice underwent axillary examination by the surgeon followed by axillary ultrasonography by a dedicated breast radiologist. Ultrasonography was performed one time from 4 to 79 months (median, 25 months) after surgery. Five patients with suspicious nodes had ultrasound-guided fine-needle aspiration, and one had a core biopsy.


RESULTS
No patient had suspicious nodes on clinical examination. Only six patients had ultrasound findings that warranted intervention. Five patients had benign cytological characteristics, and one had a benign core biopsy result. No evidence of axillary recurrence was found in any patient.


CONCLUSIONS
Axillary ultrasonography did not detect occult metastases in any patient and is not recommended for routine follow-up after SNB. The lack of ultrasound evidence of metastasis suggests that the recurrence rate is likely to remain low.
Snider
Howard C
HC
Department of Surgery, Baptist Medical Center, 2105 E. South Boulevard, Montgomery, Alabama 36116, USA. hsnidermd@pol.net
Rubin
Eva
E
Henson
Rebecca
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000000981:diagnostic imaging / Q000473:pathology*; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D021701:Sentinel Lymph Node Biopsy; D014463:Ultrasonography