Omitting axillary lymph node dissection in sentinel node negative breast cancer patients is safe: a long term follow-up analysis

Journal of Surgical Oncology
Hans TorrengaS Meijer

Abstract

To evaluate the rate of axillary recurrences in sentinel node (SN) negative breast cancer patients without further axillary lymph node dissection (ALND). Between October 1994 and November 1999, all SN negative breast cancer patients who did not underwent complete ALND were enrolled in this prospective study. SN biopsy was performed by using the triple technique which combines preoperative lymphoscintigraphy, intraoperative use of blue dye, and a handheld gamma probe to visualize and localize the SN. SNs were examined by standard hematoxylin and eosin (H&E) staining and immunohistochemistry (IHC). During the first year after surgery all patients underwent clinical examination at 3 monthly intervals. This follow-up interval was prolonged to 6 month after the first year. From the 104 patients, 93 (89%) underwent breast-conserving therapy; all remaining patients were treated by modified radical mastectomy. In 91 cases a ductal carcinoma and in 13 cases a lobular carcinoma was diagnosed. One SN was removed in 80, two SNs in 18, and three SNs in 2 patients. Twenty patients received systemic therapy based on age and primary tumor characteristics. After a median follow-up of 57 month only one axillary recurrence was observed. During fo...Continue Reading

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