Long term survival results of patients with node-negative early breast cancer receiving sentinel lymph node biopsy

Abstract

OBJECTIVES : Sentinel lymph node biopsy (SLNB) is now the gold standard in treating early breast cancers. It avoids unnecessary axillary dissection (AD) which can result in significant morbidities such as lymphedema or nerve injuries. Here we reviewed our 10-year results of patients receiving SLNB in our breast center. METHOD: We reviewed our prospectively maintained database and included all node-negative breast cancer patients who received SLNB in our breast center from January 2011–July 2011. We exclude patients who received neoadjuvant chemotherapy from our study. RESULTS : Six hundred twenty-five patients underwent SLNB in our study, 161 (25.8%) of them had macrometastasis on frozen section (FS) requiring AD. Twenty-five (4%) and 14 (2.2%) of them had micrometastasis and isolated tumor cells (ITC), respectively; all patients decided to undergo AD subsequently.After mean follow-up period of 79.5 months in patients with macrometastasis (range, 15-120 months), 14 (2.2%) had chest wall recurrence with mean time interval to recurrence of 32.1 months (range, 15-120 months). Axillary recurrence occurred in 12 patients (1.9%), with mean time interval to recurrence of 40.8 months (range, 9-97 months). Relapse in terms of distant metastasis occurred in 41 patients (6.6%) after a mean time interval of 44 months postoperatively (range, 3-97 months). After mean follow-up period of 71 months in patients with micrometastasis (range, 24-120 months) and 48 months in patients with ITC (range, 12-96 months); none of these patients develop locoregional recurrence or distant metastasis. The 5-year disease-free survival of patients with micrometastasis was 100% while that for patients with macrometastasis was 94.2%. (P value by log-rank test = <0.001). FIGURE 1. (C.F. P. 73 OF PROCEEDINGS) CONCLUSIONS : Significant difference in disease-free survival is observed between patients with macrometastasis and micrometastasis/ITC in sentinel lymph nodes. Locoregional relapse or distant metastasis after breast surgery and SLNB is extremely rare when SLNB contains only micrometastasis or ITC.