title: Regional recurrence in the era of sentinel lymph node biopsy.
abstract: BACKGROUND
  The incidence of all-location regional recurrence after sentinel lymph node biopsy is not well documented. This study attempts to identify risk factors.
  
  
  METHODS
  A prospectively maintained database was queried to identify patients with a regional recurrence of breast cancer after a first operation for invasive unilateral breast cancer. Patients with regional recurrence were compared with those alive and disease free at 5 years.
  
  
  RESULTS
  Twenty-one of 1,060 patients (2%) experienced a regional recurrence. Most patients (95%) underwent sentinel lymph node biopsy as their axillary staging. Those with regional recurrences had larger tumors (P < .001), higher stage disease (P < .001), more estrogen receptor- and triple-negative breast cancers (P < .001), and more positive lymph nodes (P = .007). Mastectomy (P = .001) and receipt of neoadjuvant and/or chemotherapy (P < .001) were more common among those with regional recurrences.
  
  
  CONCLUSIONS
  Regional recurrence of breast cancer occurs infrequently. Risk factors include high-risk cancers, higher stage at presentation, nodal involvement, and need for therapies reflecting higher risk biology.
authors.affiliation: Department of General Surgery, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Linnaus
authors.affiliation: Department of Biostatistics, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Amylou C
authors.initials: AC
authors.lastname: Dueck
authors.affiliation: Department of Biostatistics, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Kosiorek
authors.affiliation: Department of General Surgery, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gray
authors.affiliation: Department of General Surgery, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
authors.forename: Nabil
authors.initials: N
authors.lastname: Wasif
authors.affiliation: Department of Oncology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Northfelt
authors.affiliation: Department of Oncology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Anderson
authors.affiliation: Department of Pathology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Ann E
authors.initials: AE
authors.lastname: McCullough
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Wong
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Michele Y
authors.initials: MY
authors.lastname: Halyard
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Samir H
authors.initials: SH
authors.lastname: Patel
authors.affiliation: Department of General Surgery, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA. Electronic address: pockaj.barbara@mayo.edu.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D011446:Prospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy
keywords: Breast cancer; Regional recurrence; Sentinel lymph node biopsy