World Journal of Surgery

, Volume 36, Issue 4, pp 714–722

Nine years of Experience with the Sentinel Lymph Node Biopsy in a Single Italian Center: A Retrospective Analysis of 1,050 Cases


    • Department of SurgeryAzienda Ospedaliero-Univesitaria di Udine
  • Serena Bertozzi
    • Department of SurgeryAzienda Ospedaliero-Univesitaria di Udine
  • Ambrogio P. Londero
    • Clinic of Obstetrics and GynecologyUniversity Hospital of Udine
  • Francesco Giacomuzzi
    • Department of Nuclear MedicineAzienda Ospedaliero-Univesitaria di Udine
  • Vito Angione
    • Department of PathologyAzienda Ospedaliero-Univesitaria di Udine
  • Cinzia Dri
    • Department of SurgeryAzienda Ospedaliero-Univesitaria di Udine
  • Arnalda Carbone
    • Department of RadiodiagnosticsAzienda Ospedaliero-Univesitaria di Udine
  • Roberto Petri
    • Department of SurgeryAzienda Ospedaliero-Univesitaria di Udine

DOI: 10.1007/s00268-011-1420-0

Cite this article as:
Bernardi, S., Bertozzi, S., Londero, A.P. et al. World J Surg (2012) 36: 714. doi:10.1007/s00268-011-1420-0



This study aims to determine the prevalence and predictive factors for recurrence after sentinel lymph node biopsy (SLNB) and for sentinel lymph node positivity by SLNB in our population.


We followed up all SLNBs performed between 2002 and 2010 and analyzed data by R (version2.10.1), considering p < 0.05 significant.


Among 1,050 patients with SLNB, 23% (245/1050) underwent secondary axillary dissection (CALND). Axillary recurrence prevalence among patients with negative SLNB was 1% (6/805) at a mean follow-up of 54 months (±14), and 1.7% (95% CI 0.2–3.1%) after 6 years of follow-up, as all recurrences developed between the 3rd and the 6th years of follow-up. By multivariate analysis, axillary recurrence results correlated with large tumor size, high number of excised nodes, lymphovascular invasion, high grading, multifocality, Her-2 positivity, intraductal histology, and comedo-like necrosis. Moreover, SLNB positivity results correlated with young age, large tumor size, high number of excised nodes, negative history for second primary malignancies, lymphovascular invasion, and high grading.


Cancer characteristics represent important predictive factors for SLNB positivity, as well as for axillary recurrence in patients with negative SLNB, independently, by surgical and nonsurgical treatment. Therefore, cancer biological behavior and the patient’s hormonal profile should be evaluated with care to better tailor the follow-up of women with breast cancer.

Supplementary material

268_2011_1420_MOESM1_ESM.doc (33 kb)
Supplementary material 1 (DOC 33 kb)

Copyright information

© Société Internationale de Chirurgie 2012