title: A nonrandomized follow-up comparison between standard axillary node dissection and sentinel node biopsy in breast cancer.
abstract: BACKGROUND
  In many countries sentinel node biopsy (SNB) has become the standard of care in breast cancer based on a large number of observational studies but without results from prospective randomized trials. The goal of our study was to evaluate the oncological safety of the SNB in breast cancer in a multicenter, nonrandomized setting with comparable groups.
  
  
  METHODS
  Between 1996/05 and 2004/11, 2942 patients from 14 departments in Austria with unicentric, unilateral, invasive disease without neoadjuvant therapy were collected in a database. The recommendations of the Austrian Sentinel Node Study Group were to complete a training period (phase I) with 50 cases of SNB followed by axillary lymph node dissection (ALND) to prove a detection rate of > or = 90% and a false-negative rate of < or = 5%. In the executing period (phase II), SNB was followed by ALND only if the sentinel node (SN) contained metastases. We compared the results on disease-free survival, local recurrence rates, distant recurrence rates and overall survival of both groups. Cases from phases I and II generated groups I (n=671) and 2 (n=2271 cases), respectively.
  
  
  RESULTS
  Overall mean follow-up time: 34.41 months.
  
  
  CONCLUSIONS
  SNB followed by ALND only in cases with metastases in the SN is a safe procedure and at least equal to ALND in all cases.
authors.affiliation: University Hospital, Graz, Austria. peter.konstantiniuk@klinikum-graz.at
authors.forename: Peter
authors.initials: P
authors.lastname: Konstantiniuk
authors.forename: Peter
authors.initials: P
authors.lastname: Schrenk
authors.forename: Roland
authors.initials: R
authors.lastname: Reitsamer
authors.forename: Roswitha
authors.initials: R
authors.lastname: Koeberle-Wuehrer
authors.forename: Christoph
authors.initials: C
authors.lastname: Tausch
authors.forename: Sebastian
authors.initials: S
authors.lastname: Roka
authors.forename: Otto
authors.initials: O
authors.lastname: Riedl
authors.forename: Sabine
authors.initials: S
authors.lastname: Poestlberger
authors.forename: Dieter
authors.initials: D
authors.lastname: Hecke
authors.forename: Michael
authors.initials: M
authors.lastname: Janauer
authors.forename: Anton
authors.initials: A
authors.lastname: Haid
mesh_terms: D001317:Austria; D001365:Axilla / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis