Axillary recurrence after negative sentinel lymph node biopsy.
BACKGROUND
Sentinel lymph node biopsy (SLNB) has almost totally replaced axillary lymph node dissection as the first-line axillary procedure for node-negative breast cancer. SLNB has a false-negative rate of 0-22%, and regional nodal recurrence is a major concern after SLNB. In this study, we assessed axillary recurrence and risk factors in breast cancer patients 40 months after negative SLNB.


METHODS
Of 940 patients with node-negative breast cancer who underwent SLNB between December 2003 and January 2006 at Asan Medical Center, 720 were negative on SLNB, as determined using 99-m TC radiocolloid and subareolar injection technique. Of the 720 patients negative on SLNB, 174 underwent further axillary dissection, 253 underwent node sampling, and 293 received SLNB only.


RESULTS
A mean of 2.1 SLNs was removed per patient. At a median follow-up of 40 months (range 24-49 months), recurrence in the axilla was observed in three patients, all of whom had undergone SLNB only; two of these patients also had recurrences in internal mammary lymph nodes. Tumors in all three patients were hormone-receptor negative, and two were c-erbb2 negative.


CONCLUSIONS
The axillary recurrence rate was low in patients negative on SLNB. Negative hormone-receptor status and high nuclear grade may be risk factors for regional nodal failure after SLNB.
Kim
Hee Jeong
HJ
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Songpa-Gu, Seoul, Korea.
Son
Byung Ho
BH
Park
Eun Wha
EW
Lim
Woo Sung
WS
Seo
Jin Young
JY
Jang
Mi Ae
MA
Ku
Bo Kyong
BK
Ahn
Sei Hyun
SH
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy