Skip Navigation LinksHome > January 2008 - Volume 247 - Issue 1 > Axillary Recurrence Rate After Negative Sentinel Node Biopsy...
Annals of Surgery:
doi: 10.1097/SLA.0b013e318153ff40
Original Articles

Axillary Recurrence Rate After Negative Sentinel Node Biopsy in Breast Cancer: Three-Year Follow-Up of the Swedish Multicenter Cohort Study

Bergkvist, Leif MD, PhD*†; de Boniface, Jana MD, PhD*†; Jönsson, Per-Ebbe MD, PhD‡; Ingvar, Christian MD, PhD§; Liljegren, Göran MD, PhD¶∥; Frisell, Jan MD, PhD**; on behalf of the Swedish Breast Cancer Group; Swedish Society of Breast Surgeons

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Abstract

Background: Sentinel lymph node biopsy is an established staging method in early breast cancer. After a negative biopsy, most institutions will not perform a completion axillary dissection. The present study reports the current axillary recurrence (AR) rate, overall and disease-free survival in the Swedish Multicenter Cohort Study.

Methods: From 3534 patients with primary breast cancer ≤3 cm prospectively enrolled in the Swedish multicenter cohort study, 2246 with a negative sentinel node biopsy and no further axillary surgery were selected. Follow-up consisted of annual clinical examination and mammography. Twenty-six hospitals and 131 surgeons contributed to patient accrual.

Results: After a median follow-up time of 37 months (0–75), the axilla was the sole initial site of recurrence in 13 patients (13 of 2246, 0.6%). In another 7 patients, axillary relapse occurred after or concurrently with a local recurrence in the breast, and in a further 7 cases, it coincided with distant or extra-axillary lymphatic metastases. Thus, a total of 27 ARs were identified (27 of 2246, 1.2%). The overall 5-year survival was 91.6% and disease-free survival 92.1%.

Conclusions: This is the first report from a national multicenter study that covers, not only highly specialized institutions but also small community hospitals with just a few procedures per year. Despite this heterogeneous background, the results lie well within the range of AR rates published internationally (0%–3.6%). The sentinel node biopsy procedure seems to be safe in a multicenter setting. Nevertheless, long-term follow-up data should be awaited before firm conclusions are drawn.

© 2008 Lippincott Williams & Wilkins, Inc.

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