Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2005

01-01-2005 | Original Article

Axillary Recurrence After Sentinel Node Biopsy

Authors: Jacqueline Sara Jeruss, MD, PhD, David J. Winchester, MD, Stephen F. Sener, MD, Erika M. Brinkmann, MD, Malcolm M. Bilimoria, MD, Ermilo Barrera Jr., MD, Eihab Alwawi, Angel Nickolov, G. M. Schermerhorn, David J. Winchester, MD

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

Login to get access

Abstract

Background

Sentinel node biopsy (SNB) has evolved as the standard of care in the surgical staging of breast cancer. This technique is accurate for surgical staging of axillary nodal disease. We hypothesized that axillary recurrence after SNB is rare and that SNB may provide regional control in patients with microscopic nodal involvement.

Methods

With institutional review board approval, SNB was performed with peritumoral injection of 99mTc-labeled sulfur colloid. From 1996 to 2003, 1167 patients were entered into a prospective cancer database after surgical therapy; 916 patients consented to long-term follow-up. Fifty-two patients (5.7%) did not map successfully and were excluded, leading to a study population of 864 patients. The median follow-up was 27.4 months (range, 1–98 months).

Results

The median number of sentinel nodes harvested was 2, and 633 (73%) patients had negative sentinel nodes. Thirty (4.7%) of those sentinel node–negative patients underwent completion axillary dissection, whereas 592 (94%) patients were followed up with observation. A total of 231 (27%) had positive sentinel nodes: 158 (68%) of these patients underwent completion axillary dissection, and 73 (32%) were managed with observation alone. Two (.32%) patients who were sentinel node negative had an axillary recurrence; one of these patients had undergone completion axillary dissection. No patient in the observed sentinel node–positive group had an axillary recurrence (odds ratio, .37; P = .725).

Conclusions

On the basis of a median follow-up of 27.4 months, axillary recurrence after SNB is extraordinarily rare regardless of nodal involvement, thus indicating that this technique provides an accurate measure of axillary disease and may impart regional control for patients with node-positive disease.
Literature
1.
Fisher, B, Montague, E, Redmond, C,  et al. 1980Findings from NSABP Protocol No. B-04. Comparison of radical mastectomy with alternative treatments for primary breast cancerCancer46113PubMed
2.
Fisher, B, Bauer, M, Margolese, R,  et al. 1985Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancerN Engl J Med31266573PubMedCrossRef
3.
Veronesi, U, Banfi, A, De Vecchio, M, Clemente, C, Greco, M 1986Comparison of Halsted mastectomy with quadrantectomy, axillary dissection, and radiotherapy in early breast cancer: long-term resultsEur J Cancer Clin Oncol2210859PubMed
4.
Moore, M, Kinne, D 1997Axillary lymphadenectomy: a diagnostic and therapeutic procedureJ Surg Oncol6626PubMed
5.
Moore, M, Kinne, D 1996Is axillary lymph node dissection necessary in the routine management of breast cancer? YesImportant Adv Oncol2924550
6.
Blanchard, DK, Donohue, J, Reynolds, C,  et al. 2003Relapse and morbidity in patients undergoing sentinel lymph node biopsy alone or with axillary dissection for breast cancerArch Surg1384828CrossRefPubMed
7.
Reitsamer, R, Peintinger, F, Prokop, E,  et al. 2003Sentinel lymph node biopsy alone without axillary lymph node dissection–follow up of sentinel lymph node-negative breast cancer patientsEur J Surg Oncol292213CrossRefPubMed
8.
Sener, SF, Winchester, DJ, Martz, CH,  et al. 2001Lymphedema after sentinel lymphadenectomy for breast carcinomaCancer9274852CrossRefPubMed
9.
Krag, D, Weaver, D, Ashikaga, T,  et al. 1998The sentinel node in breast cancerN Engl J Med3399416CrossRefPubMed
10.
11.
Giuliano, AE, Kirgan, DM, Guenther, JM,  et al. 1994Lymphatic mapping and sentinel lymphadenectomy for breast cancerAnn Surg220391401PubMed
12.
Winchester, DJ, Sener, SF, Winchester, DP,  et al. 1999Sentinel lymphadenectomy for breast cancer: experience with 180 consecutive patients: efficacy of filtered technetium 99m sulphur colloid with overnight migration timeJ Am Coll Surg188597603PubMed
13.
Schawartz, GF, Giuliano, AE, Veronesi, U 2002The Consensus Conference Committee: proceedings of the consensus conference of the role of sentinel lymph node biopsy in carcinoma of the breast, April 19–22, 2001, Philadelphia, PennsylvaniaCancer94254251CrossRefPubMed
14.
Widt-Levert, LM, Tjan-Heijnen, VCG, Bult, P,  et al. 2003Stage migration in breast cancer: surgical decisions concerning isolated tumor cells and micro-metastases in the sentinel lymph nodeEur J Surg Oncol2921620PubMed
15.
Giuliano, AE, Haigh, PI, Brennan, MB,  et al. 2000Prospective observational study of sentinel lymphadenectomy without further axillary dissection in patients with sentinel node-negative breast cancerJ Clin Oncol1825539PubMed
16.
Chung, MA, Steinhoff, MD, Cady, B 2002Clinical axillary recurrence in breast cancer patients after a negative sentinel node biopsyAm J Surg1843104CrossRefPubMed
17.
Badgwell, BD, Povoski, SP, Abdessalam, SF,  et al. 2003Patterns of recurrence after sentinel lymph node biopsy for breast cancerAnn Surg Oncol1037680PubMed
18.
Wilke, LG, Giuliano, A 2003Sentinel lymph node biopsy in patients with early-stage breast cancer: status of the National Clinical TrialsSurg Clin North Am8390110PubMed
19.
Fant, JS, Grant, MD, Knox, SM,  et al. 2003Preliminary outcome analysis in patients with breast cancer and a positive lymph node who declined axillary dissectionAnn Surg Oncol1012630PubMed
20.
Guenther, JM, Hansen, NM, DiFronzo, A,  et al. 2003Axillary dissection is not required for all patients with breast cancer and positive sentinel lymph nodesArch Surg138526PubMedCrossRef
21.
Veronesi, U, Rilke, F, Luini, A,  et al. 1987Distribution of axillary node metastases by level of invasion. An analysis of 539 casesCancer596827PubMed
22.
Wright, FC, Walker, J, Law, L,  et al. 2003Outcomes after localized axillary node recurrence in breast cancerAnn Surg Oncol1010548PubMed
23.
Clemons, M, Danson, S, Hamilton, T, Gross, P 2001Locoregionally recurrent breast cancer: incidence, risk factors, and survivalCancer Treat Rev276782PubMed
24.
Noguchi, M 2003Is it necessary to perform prospective randomized studies before sentinel node biopsy can replace routine axillary dissection?Breast Cancer1017987CrossRefPubMed
25.
Giuliano, AE, Dale, PS, Turner, RR, Morton, DL, Evans, SW, Krasne, DL 1995Improved axillary staging of breast cancer with sentinel lymphadenectomyAnn Surg2223949PubMed
26.
Voogd, AC, Coebergh, JW, Repelaer van Dreil, OJ,  et al. 2000The risk of breast cancer metastases in breast cancer patients with clinically negative lymph nodes: a population-based analysisBreast Cancer Res Treat62639PubMed
27.
Abdessalam, SF, Zervos, EE, Prasad, M,  et al. 2001Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancerAm J Surg18231620PubMed
28.
Ahlgren, J, Holmberg, L, Bergh, J, Liljegren, G 2002Five-node biopsy of the axilla: an alternative to axillary dissection of levels I-II in operable breast cancerEur J Surg Oncol2897102PubMed
29.
Mathiesen, O, Carl, J, Bonderup, O, Panduro, J 1990Axillary sampling and the risk of erroneous staging of breast cancer. An analysis of 960 consecutive patientsActa Oncol297215PubMed
30.
Fisher, B, Brown, A, Mamounas, E,  et al. 1997Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18J Clin Oncol15248393PubMed
31.
Marschall, J, Nechala, P, Colquhoun, P,  et al. 2003Reassessing the role of axillary lymph-node dissection in patients with early-stage breast cancerCan J Surg462859PubMed
32.
Janssen, CMM, Smidt, ML, Bruggink, ED, Strobbe, LJ 2004Axillary recurrences after negative sentinel node biopsy for breast cancer: incidence and clinical significanceAnn Surg Oncol11S76
33.
Yen, TWF, Mann, GN, Lawton, TJ,  et al. 2003An axillary recurrence of breast cancer following a negative sentinel lymph node biopsyBreast J92346PubMed
34.
Salmon, RJ, Bouillet, TH, Lewis, JS, Clough, KB 2002Recurrence in the axilla after sentinel lymph node biopsy for breast cancerEur J Surg Oncol28199PubMed
35.
Schrenk, P, Hatzl-Griesenhodfer, M, Shamiyeh, A, Waynad, W 2001Follow-up of sentinel node negative breast cancer patients without axillary lymph node dissectionJ Surg Oncol7716570PubMed
36.
Roumen, RM, Kuijt, GP, Liem, IH, Beek, MW 2001Treatment of 100 patients with sentinel node-negative breast cancer without further axillary dissectionBr J Surg88163943CrossRefPubMed
Metadata
Title
Axillary Recurrence After Sentinel Node Biopsy
Authors
Jacqueline Sara Jeruss, MD, PhD
David J. Winchester, MD
Stephen F. Sener, MD
Erika M. Brinkmann, MD
Malcolm M. Bilimoria, MD
Ermilo Barrera Jr., MD
Eihab Alwawi
Angel Nickolov
G. M. Schermerhorn
David J. Winchester, MD
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/s10434-004-1164-2

Other articles of this Issue 1/2005

Annals of Surgical Oncology 1/2005 Go to the issue

Original Article

Long-Term Survival of Peritoneal Carcinomatosis of Colorectal Origin

Editorial

Simplification of Breast Cancer Surgery

Original Article

The Indications for and the Prognostic Significance of Amputation as the Primary Surgical Procedure for Localized Soft Tissue Sarcoma of the Extremity

Original Article

A Predictive Model for the Development of Hormone-Responsive Breast Cancer

Original Article

Ultrasound Examination of Sentinel Nodes in the Initial Assessment of Patients With Primary Cutaneous Melanoma

Original Article

Extent of Thyroidectomy Is Not a Major Determinant of Survival in Low- or High-Risk Papillary Thyroid Cancer