title: Axillary recurrence after negative sentinel lymph node biopsy.
abstract: 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.
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Songpa-Gu, Seoul, Korea.
authors.forename: Hee Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Eun Wha
authors.initials: EW
authors.lastname: Park
authors.forename: Woo Sung
authors.initials: WS
authors.lastname: Lim
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Seo
authors.forename: Mi Ae
authors.initials: MA
authors.lastname: Jang
authors.forename: Bo Kyong
authors.initials: BK
authors.lastname: Ku
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Ahn
mesh_terms: 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