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Axillary recurrence rate after negative sentinel node biopsy in breast cancer - Three-year follow-up of the Swedish Multicenter Cohort Study

Bergkvist, Leif; de Boniface, Jana; Jönsson, Per-Ebbe LU ; Ingvar, Christian LU ; Liljegren, Göran and Frisell, Jan (2008) In Annals of Surgery 247(1). p.150-156
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Surgery
volume
247
issue
1
pages
150 - 156
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000251982400022
  • scopus:37549047990
ISSN
1528-1140
DOI
10.1097/SLA.0b013e318153ff40
language
English
LU publication?
yes
id
7af04562-43bb-472b-bf62-7bcaf518a325 (old id 1200246)
date added to LUP
2008-09-12 11:56:06
date last changed
2017-10-29 03:44:43
@article{7af04562-43bb-472b-bf62-7bcaf518a325,
  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 &lt;= 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.},
  author       = {Bergkvist, Leif and de Boniface, Jana and Jönsson, Per-Ebbe and Ingvar, Christian and Liljegren, Göran and Frisell, Jan},
  issn         = {1528-1140},
  language     = {eng},
  number       = {1},
  pages        = {150--156},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Annals of Surgery},
  title        = {Axillary recurrence rate after negative sentinel node biopsy in breast cancer - Three-year follow-up of the Swedish Multicenter Cohort Study},
  url          = {http://dx.doi.org/10.1097/SLA.0b013e318153ff40},
  volume       = {247},
  year         = {2008},
}