Annals of Surgical Oncology

, Volume 23, Issue 8, pp 2456–2461 | Cite as

Late Axillary Recurrence After Negative Sentinel Lymph Node Biopsy is Uncommon

  • Cindy Matsen
  • Kristine Villegas
  • Anne Eaton
  • Michelle Stempel
  • Aidan Manning
  • Hiram S. Cody
  • Monica Morrow
  • Alexandra Heerdt
Breast Oncology

Abstract

Background

This study was designed to determine the incidence of late axillary recurrence (AR) in patients with negative sentinel lymph node biopsy (SLNB) and provide a comparison with SLNB positive patients who underwent axillary lymph node dissection (ALND).

Methods

Retrospective analysis of prospectively collected data on all breast cancer patients with negative SLNB from January 1997 to December 2000 was performed on a large, institutional database. Primary outcome was cumulative incidence of AR as a first event with/without concurrent local recurrence. SLNB positive patients who went on to ALND during the same timeframe were comparatively analyzed.

Results

A total of 1529 eligible patients were identified (median age 58 years, median tumor size 1.0 cm): 1297 (85 %) underwent lumpectomy; 1099 (75 %) received adjuvant radiation; and 874 (80 %) were estrogen receptor-positive. At 10.8 (range 0–16) years median follow-up, overall incidence of AR as a first event was low (n = 13). Cumulative incidence was 0.6 % [95 % confidence interval (CI) 0.2–0.9] 5 years after SLNB, and 0.9 % (95 % CI 0.4–1.4, 95 % CI 0.5–1.6) at 10 and 15 years. Late AR (>5 years after surgery) occurred in five patients. Median overall survival after AR was 4.6 years; median distant disease-free survival after AR was 3.8 years. Late AR was also low in a contemporaneous group of SLNB positive patients undergoing ALND. In this group, cumulative incidence of AR was 0.7 % (95 % CI 0.1–1.3) 5 years after surgery, and 0.8 % (95 % CI 0.2–1.5) at 10 and 15 years.

Discussion

Late AR after negative SLNB is rare; the majority of ARs are in the first 5 years after surgery. Prognosis after these events is poor. SLNB remains a safe and effective procedure for axillary evaluation in breast cancer.

Keywords

Sentinel Node Sentinel Lymph Node Biopsy Axillary Lymph Node Dissection Axillary Recurrence Negative Sentinel Lymph Node 

Notes

Acknowledgments

Funded in part by NIH/NCI Cancer Center Support Grant No. P30 CA008748.

Disclosures

The authors have no conflict of interest to disclose. All authors have read and approved the manuscript.

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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Cindy Matsen
    • 1
  • Kristine Villegas
    • 2
  • Anne Eaton
    • 3
  • Michelle Stempel
    • 2
  • Aidan Manning
    • 2
  • Hiram S. Cody
    • 2
  • Monica Morrow
    • 2
  • Alexandra Heerdt
    • 2
  1. 1.Breast Care Program, Department of SurgeryHunstman Cancer Institute at the University of UtahSalt Lake CityUSA
  2. 2.Breast Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkUSA

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