Axillary recurrence in women with a negative sentinel lymph node and no axillary dissection in breast cancer

J. Alexander Palesty, Jason M. Foster, Thelma C. Hurd, Nancy Watroba, Hamed Rezaishiraz, Stephen B. Edge

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Objectives: Sentinel lymph node biopsy (SLNB) is widely used for staging breast cancer. SLNB accurately determines axillary lymph node status with a low false negative rate. There remains concern that omitting axillary dissection may lead to recurrence in the axilla, and impact long term survival. The purpose of this study was to determine the frequency of axillary lymph node recurrence in patients who had a negative sentinel lymph node and did not undergo axillary node dissection. Methods: Data was collected on all patients who had negative SLNB at Roswell Park Cancer Institute between July 1997 and June 2002. Demographics, type of operation, postoperative systemic, and radiation therapy, co-morbidity score, hormone receptor status, and the pathologic features of the tumor were abstracted for each patient. For each woman with recurrence, the dates of recurrence, the site(s) of recurrence, and the treatment for recurrence were recorded. Results: With a median follow-up of 33 months, 15 of 335 (4.5%) women who had negative SLNBs and who did not undergo completion axillary dissection developed a cancer recurrence. Only two patients (0.6%) had an axillary recurrence. Conclusions: The rate of axillary recurrence following a negative sentinel node biopsy is the same or less than axillary lymph node dissection (ALND) alone. Concerns that omitting completion axillary dissection following a negative SLNB will increase the rate of axillary recurrence appear unfounded.

Original languageEnglish (US)
Pages (from-to)129-132
Number of pages4
JournalJournal of Surgical Oncology
Volume93
Issue number2
DOIs
StatePublished - Feb 1 2006

Fingerprint

Dissection
Breast Neoplasms
Recurrence
Sentinel Lymph Node Biopsy
Lymph Nodes
Sentinel Lymph Node
Neoplasms
Axilla
Lymph Node Excision
Radiotherapy
Demography
Hormones
Morbidity
Biopsy
Survival

Keywords

  • Axillary
  • Breast
  • Cancer
  • Node
  • Recurrence
  • Sentinel

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Axillary recurrence in women with a negative sentinel lymph node and no axillary dissection in breast cancer. / Palesty, J. Alexander; Foster, Jason M.; Hurd, Thelma C.; Watroba, Nancy; Rezaishiraz, Hamed; Edge, Stephen B.

In: Journal of Surgical Oncology, Vol. 93, No. 2, 01.02.2006, p. 129-132.

Research output: Contribution to journalArticle

Palesty, J. Alexander ; Foster, Jason M. ; Hurd, Thelma C. ; Watroba, Nancy ; Rezaishiraz, Hamed ; Edge, Stephen B. / Axillary recurrence in women with a negative sentinel lymph node and no axillary dissection in breast cancer. In: Journal of Surgical Oncology. 2006 ; Vol. 93, No. 2. pp. 129-132.
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abstract = "Objectives: Sentinel lymph node biopsy (SLNB) is widely used for staging breast cancer. SLNB accurately determines axillary lymph node status with a low false negative rate. There remains concern that omitting axillary dissection may lead to recurrence in the axilla, and impact long term survival. The purpose of this study was to determine the frequency of axillary lymph node recurrence in patients who had a negative sentinel lymph node and did not undergo axillary node dissection. Methods: Data was collected on all patients who had negative SLNB at Roswell Park Cancer Institute between July 1997 and June 2002. Demographics, type of operation, postoperative systemic, and radiation therapy, co-morbidity score, hormone receptor status, and the pathologic features of the tumor were abstracted for each patient. For each woman with recurrence, the dates of recurrence, the site(s) of recurrence, and the treatment for recurrence were recorded. Results: With a median follow-up of 33 months, 15 of 335 (4.5{\%}) women who had negative SLNBs and who did not undergo completion axillary dissection developed a cancer recurrence. Only two patients (0.6{\%}) had an axillary recurrence. Conclusions: The rate of axillary recurrence following a negative sentinel node biopsy is the same or less than axillary lymph node dissection (ALND) alone. Concerns that omitting completion axillary dissection following a negative SLNB will increase the rate of axillary recurrence appear unfounded.",
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