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

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. 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. 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. 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.

Palesty JA ，Foster JM ，Hurd TC ，Watroba N ，Rezaishiraz H ，Edge SB ... -  《JOURNAL OF SURGICAL ONCOLOGY》

Long-term morbidity of patients with early breast cancer after sentinel lymph node biopsy compared to axillary lymph node dissection.

Sentinel lymph node biopsy (SLNB) is widely accepted as an excellent method in the management of early breast cancer in patients with clinically negative axillary lymph nodes. Since SLNB requires less traumatic surgery to the axilla than axillary lymph node dissection (ALND), it was assumed to result in reduced shoulder/arm morbidity. However, data on long-term morbidity after SNLB are sparse. The present study was set up to compare long-term arm/shoulder morbidity as well as oncological outcome after SLNB versus ALND in patients with early breast cancer. Oncological outcome, objective shoulder/arm morbidity, and subjective complaints after SLNB or ALND for T1 breast cancer were assessed after a minimum follow-up of 20 months. One hundred thirty four patients were included in the study. Thirty-one patients underwent SNLB only, 103 patients had SLNB followed by ALND or ALND only. Loss of strength and hypaesthesia were less frequent after SLNB. No lymph oedema occurred after SNLB without adjuvant radiotherapy. Subjective complaints concerning pain, hypaesthesia, and paresthesia were more common in the ALND group. No axillary recurrence developed in either group. Isolated SLNB in node-negative pT1 breast cancer patients is a highly efficient tool to reduce postoperative long-term morbidity without compromising the local control of the disease. The reported ameliorations should favour SLNB as staging and treatment modality in patients suffering from early breast cancer.

Schulze T ，Mucke J ，Markwardt J ，Schlag PM ，Bembenek A ... -  《JOURNAL OF SURGICAL ONCOLOGY》

Comparison of sentinel lymph node biopsy alone and completion axillary lymph node dissection for node-positive breast cancer.

Bilimoria KY ，Bentrem DJ ，Hansen NM ，Bethke KP ，Rademaker AW ，Ko CY ，Winchester DP ，Winchester DJ ... -  《-》

Axillary regional recurrence after sentinel lymph node biopsy for breast cancer.

Rosing DK ，Dauphine CE ，Vargas MP ，Gonzalez K ，Burla M ，Kaufmann P ，Vargas HI ... -  《AMERICAN SURGEON》

Survival after negative sentinel lymph node biopsy in breast cancer at least equivalent to after negative extensive axillary dissection.

Kuijt GP ，van de Poll-Franse LV ，Voogd AC ，Nieuwenhuijzen GA ，Roumen RM ... -  《EJSO》