Axillary metastases in breast cancer patients with negative sentinel nodes: a follow-up of 3548 cases.
PREMISES: Sentinel node biopsy (SNB) in patients with breast carcinoma accurately predicts the axillary node status. However, in some 4-7% of patients with negative sentinel nodes, the remaining axillary nodes harbour cancer cells.


OBJECTIVE
Our purpose was the long-term observation of a large number of patients who did not receive axillary dissection after a negative sentinel node biopsy, in order to evaluate the incidence of overt axillary metastases.


METHODS
Patients (3548) treated from 1996 to 2004, with negative sentinel nodes not submitted to axillary dissection, were followed up to 11 years with a median follow-up of 48 months.


RESULTS
Three hundred and sixteen unfavourable events occurred among the 3548 patients, 196 of which (5.5%) related to primary breast carcinoma. Thirty one cases of overt axillary metastases were found (0.9%): they received total axillary dissection and 27 of them are at present alive and well. The 5-year overall survival rate of the whole series was 98%.


CONCLUSIONS
Patients with negative sentinel node biopsy not submitted to axillary dissection show, at follow-up, a rate of overt axillary metastases lower than expected.
Veronesi
Umberto
U
Scientific Director European Institute of Oncology, Via G. Ripamonti 435, I-20141 Milan, Italy.
Galimberti
Viviana
V
Paganelli
Giovanni
G
Maisonneuve
Patrick
P
Viale
Giuseppe
G
Orecchia
Roberto
R
Luini
Alberto
A
Intra
Mattia
M
Veronesi
Paolo
P
Caldarella
Pietro
P
Renne
Giuseppe
G
Rotmensz
Nicole
N
Sangalli
Claudia
C
De Brito Lima
Luciana
L
Tullii
Marco
M
Zurrida
Stefano
S
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D016016:Proportional Hazards Models; D011960:Receptors, Estrogen / Q000032:analysis; D012086:Reoperation; D012306:Risk; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate; D016896:Treatment Outcome
D011960:Receptors, Estrogen