title: Positive versus negative sentinel nodes in early breast cancer patients: axillary or loco-regional relapse and survival. A study spanning 2000-2012.
abstract: Sentinel Node Biopsy (SNB) is a minimally invasive alternative to elective axillary lymph node dissection (ALND) for nodal staging in early breast cancer. The present study was conducted to evaluate prognostic implications of a negative sentinel node (SN) versus a positive SN (followed by completion ALND) in a closely followed-up sample of early breast cancer patients. We studied 889 consecutive breast cancer patients operated for 908 primaries. Patients received adjuvant therapy with chemotherapy, hormone therapy and eventually trastuzumab. Radiation therapy was based on tangential radiation fields that usually included axillary level I. Median follow-up was 47 months. Axillary recurrence was seen in 1.2% (2/162) of positive SN patients, and 0.8% (5/625) of negative SN patients (p = n.s.). There was an overall 3.2% loco-regional failure rate (29/908). Incidence of distant recurrence was 3.3% (23/693) for negative SN patients, and 4.6% (9/196) for positive SN patients (p = n.s.). Overall mortality rate was 4% (8/198) for positive SN patients, while the corresponding specific mortality rate was 2.5% (5/198). For patients with negative SNs, overall mortality was 4.9% (34/693), and the specific mortality was 1.4% (19/693) (p = n.s.). We did not find significant differences in axillary/loco-regional relapse, distant metastases, disease-free interval or mortality between SN negative and SN positive patients, with a follow-up over 4 years.
authors.affiliation: Breast Unit, Department of Gynecology, CTD, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Spain; Department of Gynecology, Catalan Institute of Health, Mollet del Vallès, Barcelona, Spain. Electronic address: agarcia@mutuaterrassa.es.
authors.forename: A
authors.initials: A
authors.lastname: García Fernández
authors.forename: C
authors.initials: C
authors.lastname: Chabrera
authors.forename: M
authors.initials: M
authors.lastname: García Font
authors.forename: M
authors.initials: M
authors.lastname: Fraile
authors.forename: J M
authors.initials: JM
authors.lastname: Lain
authors.forename: I
authors.initials: I
authors.lastname: Barco
authors.forename: C
authors.initials: C
authors.lastname: González
authors.forename: S
authors.initials: S
authors.lastname: Gónzalez
authors.forename: A
authors.initials: A
authors.lastname: Reñe
authors.forename: E
authors.initials: E
authors.lastname: Veloso
authors.forename: J
authors.initials: J
authors.lastname: Cassadó
authors.forename: A
authors.initials: A
authors.lastname: Pessarrodona
authors.forename: N
authors.initials: N
authors.lastname: Giménez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001365:Axilla; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011237:Predictive Value of Tests; D018714:Radiotherapy, Adjuvant; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents
keywords: Breast neoplasms; Mortality; Neoplasm recurrence; Sentinel lymph node biopsy; Survival