Late axillary recurrence after negative sentinel lymph node biopsy is uncommon Journal Article


Authors: Matsen, C.; Villegas, K.; Eaton, A.; Stempel, M.; Manning, A.; Cody, H. S. 3rd; Morrow, M.; Heerdt, A.
Article Title: Late axillary recurrence after negative sentinel lymph node biopsy is uncommon
Abstract: 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). 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. 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. 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: chemotherapy; lymphadenectomy; mastectomy; radiotherapy; dissection; follow-up; randomized-trial; breast-cancer patients; multicenter; locoregional recurrence
Journal Title: Annals of Surgical Oncology
Volume: 23
Issue: 8
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2016-08-01
Start Page: 2456
End Page: 2461
Language: English
ACCESSION: WOS:000379189900015
DOI: 10.1245/s10434-016-5151-1
PROVIDER: wos
PMCID: PMC4972036
PUBMED: 26957506
Notes: Article -- Source: Wos
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MSK Authors
  1. Monica Morrow
    772 Morrow
  2. Hiram S Cody III
    242 Cody
  3. Alexandra S Heerdt
    110 Heerdt
  4. Anne Austin Eaton
    122 Eaton
  5. Michelle Moccio Stempel
    153 Stempel