Axillary Recurrence after Negative Sentinel Lymph Node Biopsy: Frequency and Factors Influencing Recurrence on the Long Term

Abstract:  Sentinel lymph node (SLN) biopsy is a less invasive method for determining tumor stage. Purpose of this study was to determine the frequency of axillary recurrence after negative SLN biopsy for women with breast cancer. A total of 121 patients with a negative SLN biopsy, from January 1, 2000 to December 31, 2004, were identified from a maintained pathology database. Retrospective chart review and data analysis were performed until September 1, 2006, to determine frequency of axillary recurrence and identify variables predictive of recurrence. Two hundred and sixty eight patients had undergone SLN biopsy in the researched period, of which 121 were SLN negative and had no further axillary treatment. The median follow-up was 44 months (range, 15–76 months). Three patients (2.5%) developed isolated axillary recurrence. Five patients (4.1%) developed distant disease recurrence. Grade 3 tumor differentiation was significantly associated with tumor recurrence. Tumor size, hormone receptor state, and mitotic activity/2 mm² were not significantly associated with disease recurrence. Patients with a negative SLN biopsy with no further axillary treatment, show a low rate of axillary recurrence. SLN biopsy is a less invasive and accurate method for determining tumor stage and a negative SLN biopsy provides good regional control of the axilla on the long term.