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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2005

01-01-2005 | Original Article

Axillary Recurrence After a Negative Sentinel NodeBiopsy for Breast Cancer: Incidence and Clinical Significance

Authors: Marjolein L. Smidt, MD, Caroline M. M. Janssen, MD, Deborah M. Kuster, MD, Erik D. M. Bruggink, MD, PhD, Luc J. A. Strobbe, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2005

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Abstract

Background

Sentinel lymph node biopsy (SLNB) carries the inherent risk of approximately 5% false-negative sampling. Undetected tumor-positive nodes of clinical importance are those that lead to axillary recurrence. This survey aims at clarifying the extent of this problem in current practice and literature.

Methods

In a regional teaching hospital, 696 consecutive breast cancer patients underwent SLNB between January 1998 and July 2003, and data were entered in a prospective database. PubMed and the Cochrane library were searched for a systematic review of the literature. Thirteen studies dealt with the follow-up of a cohort of sentinel lymph node (SLN)-negative patients or presented a case report.

Results

The SLN identification rate was 97.1%. The SLN was tumor free in 439 (65%) of the 676 patients. After a median follow-up of 26 months, axillary recurrence was detected in 2 of 439 patients 4 and 27 months after the SLNB. The incidence of clinically apparent false-negative SLNB is .46%. The systematic review resulted in 3184 SLNB-negative patients with a median follow-up of 25 months. Axillary recurrence occurred in eight patients after a median of 21 months. The axillary recurrence rate in the literature is .25%. One third of these patients present with synchronous systemic metastases.

Conclusions

Axillary recurrences after a negative SLNB occur, but at a much lower rate than would be expected on the basis of historical figures and the false-negative SLN findings. The natural history of axillary relapse after negative SLNB resembles the locoregional recurrence of breast cancer.
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Metadata
Title
Axillary Recurrence After a Negative Sentinel NodeBiopsy for Breast Cancer: Incidence and Clinical Significance
Authors
Marjolein L. Smidt, MD
Caroline M. M. Janssen, MD
Deborah M. Kuster, MD
Erik D. M. Bruggink, MD, PhD
Luc J. A. Strobbe, MD, PhD
Publication date
01-01-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1007/s10434-004-1166-0

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