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The Effect of Sentinel Node Tumor Burden on Non–Sentinel Node Status and Recurrence Rates in Breast Cancer

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An Erratum to this article was published on 05 September 2005

Abstract

Background

Routine axillary lymph node dissection (ALND) after selective sentinel lymphadenectomy (SSL) in the treatment of breast cancer remains controversial. We sought to determine the need for routine ALND by exploring the relationship between sentinel lymph node (SLN) and non-SLN (NSLN) status. We also report our experience with disease relapse in the era of SSL and attempt to correlate this with SLN tumor burden.

Methods

This was a retrospective study of 390 patients with invasive breast cancer treated at a single institution who underwent successful SSL from November 1997 to November 2002.

Results

Of the 390 patients, 115 received both SSL and ALND. The percentage of additional positive NSLNs in the SLN-positive group (34.2%) was significantly higher than in the SLN-negative group (5.1%; P = .0004). The SLN macrometastasis group had a significantly higher rate of positive NSLNs (39.7%) compared with the SLN-negative group (5.1%; P = .0001). Sixteen patients developed recurrences during follow-up, including 6.1% of SLN-positive and 3.3% of SLN-negative patients. Among the SLN macrometastasis group, 8.7% had recurrence, compared with 2.2% of SLN micrometastases over a median follow-up period of 31.1 months. One regional failure developed out of 38 SLN-positive patients who did not undergo ALND.

Conclusions

ALND is recommended for patients with SLN macrometastasis because of a significantly higher incidence of positive NSLNs. Higher recurrence rates are also seen in these patients. However, the role of routine ALND in patients with a low SLN tumor burden remains to be further determined by prospective randomized trials.

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Authors and Affiliations

  1. Department of Surgery, University of California San Francisco Medical Center at Mount Zion, and University of CaliforniaSan Francisco Comprehensive Cancer Center, 1600 Divisadero Street, San Francisco, 94143-1674, California

    Yang-Guo Fan MD, Yah-Yuen Tan FRCS, Chen-Teng Wu MD, Chung-Wei Chan BS, Shelley Hwang MD, Cheryl Ewing MD, Laura Esserman MD & Stanley P. L. Leong MD

  2. Department of Pathology, University of California San Francisco Medical Center, Room M-551, Box 0102, San Francisco, 94143-0102, California

    Patrick Treseler MD

  3. Departments of Radiology and Epidemiology and Biostatistics, and University of California San Francisco Comprehensive Cancer Center, University of California, San Francisco, CA, 94143-0946

    Ying Lu PhD

  4. Department of Nuclear Medicine, University of California San Francisco Medical Center at Mount Zion, 1600 Divisadero Street, San Francisco, 94143-1667, California

    Eugene Morita MD

Authors
  1. Yang-Guo Fan MD
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  2. Yah-Yuen Tan FRCS
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  3. Chen-Teng Wu MD
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  4. Patrick Treseler MD
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  5. Ying Lu PhD
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  6. Chung-Wei Chan BS
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  7. Shelley Hwang MD
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  8. Cheryl Ewing MD
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  9. Laura Esserman MD
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  10. Eugene Morita MD
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  11. Stanley P. L. Leong MD
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Corresponding author

Correspondence to Stanley P. L. Leong MD.

Additional information

Published by Springer Science+Business Media, Inc. © 2005 The Society of Surgical Oncology, Inc.

An erratum to this article is available at http://dx.doi.org/10.1245/ASO.2005.08.513.

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Fan, YG., Tan, YY., Wu, CT. et al. The Effect of Sentinel Node Tumor Burden on Non–Sentinel Node Status and Recurrence Rates in Breast Cancer. Ann Surg Oncol 12, 705–711 (2005). https://doi.org/10.1245/ASO.2005.08.020

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  • DOI: https://doi.org/10.1245/ASO.2005.08.020

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