title: Sentinel node biopsy alone for node-positive breast cancer: 12-year experience at a single institution.
abstract: BACKGROUND
  Complete node dissection for a tumor-positive sentinel node (SN) is becoming more controversial. We report our institution's 12-year experience with sentinel node biopsy (SNB) alone for a tumor-positive SN.
  
  
  METHODS
  This was a retrospective review from 1998 to 2009. Of 3,806 patients who underwent SNB, 2,139 underwent SNB alone, of which 1,997 were tumor-negative and 123 were tumor-positive. SNs were staged node-positive (N1mic or N1) according to American Joint Committee on Cancer criteria.
  
  
  RESULTS
  One hundred and twenty-three node-positive patients underwent SNB alone with no completion axillary dissection for invasive breast cancer. Mean age was 57 years (range 32 to 92 years) and stage distribution was as follows: stage IIA: 76 (62%) patients; stage IIB: 40 (33%) patients; and stage III: 4 patients (3%). Mean size of the tumors was 1.9 cm (range 0.1 to 9 cm). Eighty-nine (72%) underwent lumpectomy and 34 (28%) underwent mastectomy. Ninety-three percent of patients underwent some form of adjuvant therapy. Forty-two patients (34%) did not undergo radiation and there were no axillary recurrences in this group. At median follow-up of 95 months, there has been 1 axillary recurrence (0.8%) and 13 deaths, 4 of which were attributed to metastatic breast cancer and the rest to non-breast-related causes.
  
  
  CONCLUSIONS
  Axillary recurrence is rare after SN biopsy alone. This might be related to favorable tumor and patient characteristics and frequent use of adjuvant therapy.
authors.affiliation: Department of Surgery, University of Chicago, Chicago, IL 60201, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Spiguel
authors.forename: Katharine
authors.initials: K
authors.lastname: Yao
authors.forename: David J
authors.initials: DJ
authors.lastname: Winchester
authors.forename: Addie
authors.initials: A
authors.lastname: Gorchow
authors.forename: Hongyan
authors.initials: H
authors.lastname: Du
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Sener
authors.forename: Brigid
authors.initials: B
authors.lastname: Martz
authors.forename: Mary
authors.initials: M
authors.lastname: Turk
authors.forename: Ermilo
authors.initials: E
authors.lastname: Barrera
authors.forename: David P
authors.initials: DP
authors.lastname: Winchester
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome