Axillary recurrence after sentinel lymph node biopsy for breast cancer

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Sentinel lymph node biopsy (SLNB) is standard for axillary staging in breast cancer.
• A known false-negative rate of up to 10% exists, but axillary recurrence is infrequent.
• Previous studies showed a 1% recurrence rate at 2-year follow-up.

Purpose of the Study:

• To evaluate the long-term rate of axillary recurrence after negative SLNB in breast cancer patients.
• To assess recurrence risk in specific higher-risk subgroups, including those receiving neoadjuvant therapy or with isolated tumor cells (ITCs).

Main Methods:

• Retrospective review of invasive breast cancer patients with negative SLNB between 2001-2005.
• Inclusion of patients who received neoadjuvant therapy or had ITCs.
• Exclusion of patients with less than 18 months of follow-up.

Main Results:

• One out of 139 patients (0.7%) experienced axillary recurrence after a median follow-up of 52 months.
• No axillary recurrence was observed in patients who received neoadjuvant chemotherapy or had ITCs.
• Twelve patients (8.6%) died, with three deaths attributed to breast cancer.

Conclusions:

• Axillary recurrence after a negative SLNB is a rare event, even with extended follow-up and in higher-risk scenarios.
• Axillary lymph node dissection can be safely omitted in patients with negative SLNB results.
• SLNB is a reliable method for axillary staging in breast cancer, minimizing the need for more extensive surgery.