title: Breast cancer recurrence after sentinel lymph node biopsy.
abstract: OBJECTIVE
  To look into the pattern of breast cancer recurrence following mastectomy, breast conservative surgery and radiotherapy or chemotherapy after SLNB at our institution.
  
  
  METHODS
  Between January 2005 and December 2014, all patients diagnosed with breast cancer with clinically negative axilla, underwent SLNB. We reviewed their medical records to identify pattern of cancer recurrence.
  
  
  RESULTS
  The median follow-up was 35.5 months. Eighty five patients (70.8%) had a negative sentinel lymph node (SLN) and subsequently had no further axillary treatment, one of them (1.2%) developed axillary recurrence 25 months postoperatively. Twenty five patients (20.8%) had a positive SLN (macrometastases) and subsequently had immediate axillary lymph node dissection (ALND). Ten patients (8.3%) had a positive SLN (micrometastases). In the positive SLN patients (macrometastases and micrometastases), there were two ipsilateral breast recurrences (5.7%), seen three and four years postoperatively. Also in this group, there was one (2.9%) distant metastasis to bone three years postoperatively.
  
  
  CONCLUSIONS
  In this series, the clinical axillary false negative rate for SLNB was 1.2% which is in accordance with the published literature. This supports the use of SLNB as the sole axillary staging procedure in breast cancer patients with negative SLNB. Axillary lymph node dissection can be safely omitted in patients with micrometastases in their sentinel lymph node(s).
authors: Dr. Abdulaziz A. Alsaif, Associate Professor of Surgery, King Saud University, Department of Surgery, P.O. Box 59854, Riyadh 11535, Saudi Arabia.
authors: Abdulaziz
authors: A
authors: AlSaif
keywords: Breast cancer; Cancer recurrence; Sentinel lymph node biopsy