Axillary recurrence after negative sentinel lymph node biopsy under local anesthesia in breast cancer.
The procedure known as sentinel lymph node biopsy (SLNB) under local anesthesia (LA) allows surgical teams to avoid the uncertainties of frozen tissue examination and to perform axillary dissection on patients who have been informed of the risks of lymph node invasion prior to the procedure.


OBJECTIVE
In the absence of studies that assess the risk of obtaining false negatives during SLNB under LA, we believed it would be relevant to do a study of the safety of SLNB under LA to ensure that the risk of axillary recurrence is as low as with SLNB carried out in the traditional manner under general anesthesia. Through the experience of the Department of Gynecological Surgery at the Limoges CHU, we were able to assess the risk of axillary recurrence after SLNB under LA.


METHODS
Between July 2001 and November 2008, 319 SLNB under LA was performed in cases of invasive breast cancer. Axillary dissection was done in 125 cases. In total, 194 patients underwent SLNB with no lymph node invasion and without additional axillary dissection. Follow-up was monitored until May 30, 2008.


RESULTS
With a median follow-up period of 39.5 months, there were no patients with axillary recurrence. We recorded 6 local recurrences and 3 distant metastases.


CONCLUSIONS
With an experienced team, SLNB under LA is a procedure that does not expose patients to a greater risk of axillary recurrence than SLNB carried out in the traditional manner under general anesthesia.
Gauthier
T
T
Department of Gynecology, Hospital Mère Enfant, CHU Dupuytren, Rue Larrey, 87000 Limoges, France. gauthiertristan@yahoo.fr
Mollard
J
J
Fermeaux
V
V
Kapella
M
M
Aubard
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy