BACKGROUND: Sentinel lymph node biopsy (SLNB) carries the inherent risk of approximately 5% false-negative sampling. Undetected tumor-positive nodes of clinical importance are those that lead to axillary recurrence. This survey aims at clarifying the extent of this problem in current practice and literature. METHODS: In a regional teaching hospital, 696 consecutive breast cancer patients underwent SLNB between January 1998 and July 2003, and data were entered in a prospective database. PubMed and the Cochrane library were searched for a systematic review of the literature. Thirteen studies dealt with the follow-up of a cohort of sentinel lymph node (SLN)-negative patients or presented a case report. RESULTS: The SLN identification rate was 97.1%. The SLN was tumor free in 439 (65%) of the 676 patients. After a median follow-up of 26 months, axillary recurrence was detected in 2 of 439 patients 4 and 27 months after the SLNB. The incidence of clinically apparent false-negative SLNB is .46%. The systematic review resulted in 3184 SLNB-negative patients with a median follow-up of 25 months. Axillary recurrence occurred in eight patients after a median of 21 months. The axillary recurrence rate in the literature is .25%. One third of these patients present with synchronous systemic metastases. CONCLUSIONS: Axillary recurrences after a negative SLNB occur, but at a much lower rate than would be expected on the basis of historical figures and the false-negative SLN findings. The natural history of axillary relapse after negative SLNB resembles the locoregional recurrence of breast cancer.
BACKGROUND: Sentinel lymph node biopsy (SLNB) carries the inherent risk of approximately 5% false-negative sampling. Undetected tumor-positive nodes of clinical importance are those that lead to axillary recurrence. This survey aims at clarifying the extent of this problem in current practice and literature. METHODS: In a regional teaching hospital, 696 consecutive breast cancerpatients underwent SLNB between January 1998 and July 2003, and data were entered in a prospective database. PubMed and the Cochrane library were searched for a systematic review of the literature. Thirteen studies dealt with the follow-up of a cohort of sentinel lymph node (SLN)-negative patients or presented a case report. RESULTS: The SLN identification rate was 97.1%. The SLN was tumor free in 439 (65%) of the 676 patients. After a median follow-up of 26 months, axillary recurrence was detected in 2 of 439 patients 4 and 27 months after the SLNB. The incidence of clinically apparent false-negative SLNB is .46%. The systematic review resulted in 3184 SLNB-negative patients with a median follow-up of 25 months. Axillary recurrence occurred in eight patients after a median of 21 months. The axillary recurrence rate in the literature is .25%. One third of these patients present with synchronous systemic metastases. CONCLUSIONS: Axillary recurrences after a negative SLNB occur, but at a much lower rate than would be expected on the basis of historical figures and the false-negative SLN findings. The natural history of axillary relapse after negative SLNB resembles the locoregional recurrence of breast cancer.
Authors: Martin Sillem; Urban Bromberger; Barbara Heitzelmann; Wolfgang J Brauer; Martin Werner; Sylvia Timme Journal: Breast Care (Basel) Date: 2015-12-21 Impact factor: 2.860
Authors: T Rosenow; C Biedendieck; H Fricke; M Brinkmann; U Cirkel; W-D Reinbold; E Fricke Journal: Geburtshilfe Frauenheilkd Date: 2012-11 Impact factor: 2.915
Authors: Viviana Galimberti; Bernard F Cole; Stefano Zurrida; Giuseppe Viale; Alberto Luini; Paolo Veronesi; Paola Baratella; Camelia Chifu; Manuela Sargenti; Mattia Intra; Oreste Gentilini; Mauro G Mastropasqua; Giovanni Mazzarol; Samuele Massarut; Jean-Rémi Garbay; Janez Zgajnar; Hanne Galatius; Angelo Recalcati; David Littlejohn; Monika Bamert; Marco Colleoni; Karen N Price; Meredith M Regan; Aron Goldhirsch; Alan S Coates; Richard D Gelber; Umberto Veronesi Journal: Lancet Oncol Date: 2013-03-11 Impact factor: 41.316
Authors: Arpana M Naik; Jane Fey; Mary Gemignani; Alexandra Heerdt; Leslie Montgomery; Jeanne Petrek; Elisa Port; Virgilio Sacchini; Lisa Sclafani; Kimberly VanZee; Raquel Wagman; Patrick I Borgen; Hiram S Cody Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
Authors: Jacqueline S Jeruss; Lisa A Newman; Gregory D Ayers; Massimo Cristofanilli; Kristine R Broglio; Funda Meric-Bernstam; Min Yi; Jennifer F Waljee; Merrick I Ross; Kelly K Hunt Journal: Cancer Date: 2008-06-15 Impact factor: 6.860