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Annals of Oncology Advance Access originally published online on June 10, 2008
Annals of Oncology 2008 19(11):1842-1846; doi:10.1093/annonc/mdn393
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

breast cancer

Axillary recurrence in sentinel lymph node-negative breast cancer patients

P. Poletti1,*, P. Fenaroli2, A. Milesi1, A. Paludetti2, S. Mangiarotti2, G. Virotta3, E. Candiago4, A. Bettini1, E. R. Caremoli1, R. Labianca1 and C. Tondini1

1 Department of Medical Oncology
2 Breast Unit
3 Department of Nuclear Medicine
4 Department of Pathology, Ospedali Riuniti di Bergamo, Bergamo, Italy

* Correspondence to: Dr P. Poletti, Unità Operativa di Oncologia medica, Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24128 Bergamo, Italy. Tel: +39-035-269724; Fax: +39-035-266173; E-mail: ppoletti{at}ospedaliriuniti.bergamo.it

Background: Sentinel lymph node biopsy (SLNB) was developed to axillary lymph node dissection (ALND) in the treatment of breast cancer. SLNB is predictive of axillary node status. Major concern is the occurrence of a false-negative SLN. Purpose of this study is to determine the rate of axillary recurrence in our series of unselected patients.

Patients and methods: All patients with a negative SLNB from November 1999 to December 2006 have been treated and followed at our unit. Information on patients' characteristics, treatment and follow-up has been collected.

Results: Eight-hundred and four patients with negative SLNB did not receive ALND. After a median follow-up of 38.8 months, 21 patients had distant metastases, four had axillary relapse, nine had an in-breast recurrence and two had both. All patients with axillary recurrence received axillary dissection and systemic adjuvant therapy. They are all presently alive and free from disease.

Conclusion: Data from this series, the largest from a general hospital, showed that isolated axillary node recurrence after negative SLNB is rare (<1%) and comparable with those reported from referral cancer institutions. We confirm that SLNB for the treatment of early breast cancer patients of a community-based hospital is safe and reliable.

Key words: axillary lymph node recurrence, breast cancer, sentinel lymph node biopsy

Received for publication May 6, 2008. Accepted for publication May 19, 2008.


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