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Axillary lymph node dissection can be avoided in women with breast cancer with intraoperative, false-negative sentinel lymph node biopsies

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Abstract

Background

It is currently unclear which patients with breast cancer with sentinel lymph node (SLN) metastases do not need axillary lymph node dissection (ALND).

Patients and methods

A cohort of 1,132 women who had unilateral invasive breast cancer with clinically negative nodes or nodes suspicious for metastasis, were intraoperatively diagnosed as having negative SLNs, and did not undergo an immediate ALND. Our intraoperative histological investigation uses H&E staining of a frozen section from a maximum cut surface of each SLN. Of these 1,132 women, 132 (11.7%) were postoperatively diagnosed as having positive SLNs, which classifies them as having an intraoperative, false-negative SLN biopsy (SLNB). Patient and tumor characteristics, treatment methods, and the prognoses of these patients were investigated and compared with the remaining 1,000 patients who were negative for SLNB.

Results

Of the 132 patients with intraoperative, false-negative SLNB, none underwent a further ALND. With a median follow-up period of 58.1 months, none of these patients exhibited recurrence in the axillary nodes. Their recurrence-free survival rates were not statistically different from those of patients with negative SLNB.

Conclusions

ALND can be avoided in most patients with breast cancer with intraoperative, false-negative SLNB.

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Abbreviations

ALND:

Axillary lymph node dissection

CI:

Confidence interval

IDC NOS:

Invasive ducal carcinoma not otherwise specified

ITCs:

Isolated tumor cells

LVI:

Lymphovascular invasion

SLN:

Sentinel lymph node

SLNB:

Sentinel lymph node biopsy

RT:

Radiation therapy

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Acknowledgment

This study was supported in part by Grants-in-Aid for Cancer Research from the Ministry of Health, Labor and Welfare of Japan.

Conflict of interest statement

There is no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Breast Surgery, Saitama Cancer Center, 818 Komuro Ina, Kita-Adachi, Saitama, 362-0806, Japan

    Hiroyuki Takei, Takashi Yoshida, Yuko Ishikawa, Yuji Hayashi, Jun Ninomiya & Katsunori Tozuka

  2. Department of Pathology, Saitama Cancer Center, 818 Komuro Ina, Kita-Adachi, Saitama, 362-0806, Japan

    Masafumi Kurosumi & Hanako Oba

  3. Division of Breast Oncology, Saitama Cancer Center, 818 Komuro Ina, Kita-Adachi, Saitama, 362-0806, Japan

    Kenichi Inoue, Shigenori Nagai & Toshio Tabei

  4. Department of Radiology, Saitama Cancer Center, 818 Komuro Ina, Kita-Adachi, Saitama, 362-0806, Japan

    Yoshihiro Saito, Tomoko Kazumoto & Jun-ichi Saitoh

Authors
  1. Hiroyuki Takei
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  2. Masafumi Kurosumi
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  3. Takashi Yoshida
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  4. Yuko Ishikawa
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  13. Jun-ichi Saitoh
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  14. Toshio Tabei
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Corresponding author

Correspondence to Hiroyuki Takei.

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Takei, H., Kurosumi, M., Yoshida, T. et al. Axillary lymph node dissection can be avoided in women with breast cancer with intraoperative, false-negative sentinel lymph node biopsies. Breast Cancer 17, 9–16 (2010). https://doi.org/10.1007/s12282-009-0154-4

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  • DOI: https://doi.org/10.1007/s12282-009-0154-4

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