Axillary recurrence after negative sentinel lymph node biopsy |
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Authors: | Hee Jeong Kim Byung Ho Son Eun Wha Park Woo Sung Lim Jin Young Seo Mi Ae Jang Bo Kyong Ku Sei Hyun Ahn |
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Affiliation: | (1) Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, 388 Songpa-gu, Poongnap-dong, Seoul, Korea |
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Abstract: | Background Sentinel lymph node biopsy (SLNB) has almost totally replaced axillary lymph node dissection as the first-line axillary procedure for node-negative breast cancer. SLNB has a false-negative rate of 0–22%, and regional nodal recurrence is a major concern after SLNB. In this study, we assessed axillary recurrence and risk factors in breast cancer patients 40 months after negative SLNB. Methods Of 940 patients with node-negative breast cancer who underwent SLNB between December 2003 and January 2006 at Asan Medical Center, 720 were negative on SLNB, as determined using 99-m TC radiocolloid and subareolar injection technique. Of the 720 patients negative on SLNB, 174 underwent further axillary dissection, 253 underwent node sampling, and 293 received SLNB only. Results A mean of 2.1 SLNs was removed per patient. At a median follow-up of 40 months (range 24–49 months), recurrence in the axilla was observed in three patients, all of whom had undergone SLNB only; two of these patients also had recurrences in internal mammary lymph nodes. Tumors in all three patients were hormone-receptor negative, and two were c-erbb2 negative. Conclusion The axillary recurrence rate was low in patients negative on SLNB. Negative hormone-receptor status and high nuclear grade may be risk factors for regional nodal failure after SLNB. |
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Keywords: | Sentinel lymph node biopsy Recurrence |
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