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Axillary recurrence after sentinel lymph node biopsy.

B van der Vegt1, M H E Doting, P L Jager

  • 1Department of Surgical Oncology, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|August 7, 2004
PubMed
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Sentinel lymph node biopsy (SLNB) without axillary lymph node dissection (ALND) is safe for patients with negative sentinel nodes in breast cancer. This approach ensures locoregional control with a low false-negative rate of 1% during follow-up.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Sentinel lymph node biopsy (SLNB) is a staging procedure for breast cancer.
  • Axillary lymph node dissection (ALND) is often performed after positive SLNB.
  • The role of omitting ALND in sentinel node-negative breast cancer requires further evaluation.

Purpose of the Study:

  • To evaluate the safety and efficacy of SLNB without completion ALND in breast cancer patients with tumor-negative sentinel nodes.
  • To determine the locoregional control and false-negative rate in this patient group.
  • To provide follow-up data for patients undergoing SLNB without ALND.

Main Methods:

  • Prospective study of 185 patients with primary operable breast carcinoma.
  • SLNB performed using lymphoscintigraphy, vital blue dye, and gamma probe.

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  • Patients with tumor-positive SLNs received completion ALND; all patients followed regional protocols.

    • Main Results:

    • Sentinel lymph nodes (SLNs) were identified in 179 patients.
    • 73 patients had tumor-positive SLNs, and 106 had tumor-negative SLNs.
    • A median follow-up of 35 months revealed one axillary recurrence in an SLN-negative patient (1% false-negative rate).

    Conclusions:

    • SLNB without ALND is a safe and effective procedure for locoregional control in SLN-negative breast carcinoma.
    • This approach is reliable when performed by experienced surgical teams.
    • Omitting ALND in selected breast cancer patients can be considered based on these findings.