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Influencing factors for regional lymph node recurrence of breast cancer

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Abstract

Introduction

We investigated whether the risk of developing regional lymph node recurrence was dependant on the number of lymph nodes removed.

Object

We followed 2,961 patients of whom 50 (1.69%) developed regional recurrent disease during a median period of 73 months (4–192 months).

Result

For those women who had involved lymph nodes at initial surgery we were able to establish an inverse correlation between the development of local recurrence and the number of lymph nodes removed in multivariate analysis. For women who had no affected lymph nodes, the number of lymph nodes removed did not influence the incidence of local recurrence.

Conclusion

We conclude from these data that women who have negative nodal status at surgical staging do not benefit from further systematic axillary resection with regard to regional lymph node recurrence. For those women, however, who have confirmed axillary metastasis, systematic axillary resection lowers the risk of regional lymph node recurrence depending on the number of lymph nodes removed.

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References

  1. Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku N, Shivers S, Berman C, Wells K, Rapaport D, Shons A, Horton J, Greenberg H, Nicosia S, Clark R, Cantor A, Reintgen DS (1996) Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA 276(22):1818–1822

    Article  PubMed  CAS  Google Scholar 

  2. Carlo JT, Grant MD, Knox SM, Jones RC, Hamilton CS, Livingston SA, Kuhn JA (2005) Survival analysis following sentinel lymph node biopsy: a validation trial demonstrating its accuracy in staging early breast cancer. Proc (Bayl Univ Med Cent) 18(2):103–107

    Google Scholar 

  3. Chung MA, Steinhoff MM, Cady B (2002) Clinical axillary recurrence in breast cancer patients after a negative sentinel node biopsy. Am J Surg 184(4):310–314

    Article  PubMed  Google Scholar 

  4. Cox DR (1972) Regression models and life-tables. J R Stat Soc 34:187–220

    Google Scholar 

  5. Cserni G (1999) Estimating the overlap between sentinel lymph nodes and axillary node samples in breast cancer. Pathol Oncol Res 5(2):129–133

    Article  PubMed  CAS  Google Scholar 

  6. Fowble B, Solin LJ, Schultz DJ, Goodman RL (1989) Frequency, sites of relapse, and outcome of regional node failures following conservative surgery and radiation for early breast cancer. Int J Radiat Oncol Biol Phys 17(4):703–710

    PubMed  CAS  Google Scholar 

  7. Giuliano AE, Haigh PI, Brennan MB, Hansen NM, Kelley MC, Ye W, Glass EC, Turner RR (2000) Prospective observational study of sentinel lymphadenectomy without further axillary dissection in patients with sentinel node-negative breast cancer. J Clin Oncol 18(13):2553–2559

    PubMed  CAS  Google Scholar 

  8. Giuliano AE, Kirgan DM, Guenther JM, Morton DL (1994) Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 220(3):391–398

    Article  PubMed  CAS  Google Scholar 

  9. Hack TF, Cohen L, Katz J, Robson LS, Goss P (1999) Physical and psychological morbidity after axillary lymph node dissection for breast cancer. J Clin Oncol 17(1):143–149

    PubMed  CAS  Google Scholar 

  10. Haid A, Koberle-Wuhrer R, Knauer M, Burtscher J, Fritzsche H, Peschina W, Jasarevic Z, Ammann M, Hergan K, Sturn H, Zimmermann G (2002) Morbidity of breast cancer patients following complete axillary dissection or sentinel node biopsy only: a comparative evaluation. Breast Cancer ResTreat 73(1):31–36

    Article  Google Scholar 

  11. Hansen NM, Grube BJ, Giuliano AE (2002) The time has come to change the algorithm for the surgical management of early breast cancer. Arch Surg 137(10):1131–1135

    Article  PubMed  Google Scholar 

  12. Harris EE, Hwang WT, Seyednejad F, Solin LJ (2003) Prognosis after regional lymph node recurrence in patients with stage I–II breast carcinoma treated with breast conservation therapy. Cancer 98(10):2144–2151

    Article  PubMed  Google Scholar 

  13. Ivens D, Hoe AL, Podd TJ, Hamilton CR, Taylor I, Royle GT (1992) Assessment of morbidity from complete axillary dissection. Br J Cancer 66(1):136–138

    PubMed  CAS  Google Scholar 

  14. Jeruss JS, Winchester DJ, Sener SF, Brinkmann EM, Bilimoria MM, Barrera E Jr, Alwawi E, Nickolov A, Schermerhorn GM, Winchester DJ (2005) Axillary recurrence after sentinel node biopsy. Ann Surg Oncol 12(1):34–40

    Article  PubMed  Google Scholar 

  15. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  16. Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, Feldman S, Kusminsky R, Gadd M, Kuhn J, Harlow S, Beitsch P (1998) The sentinel node in breast cancer—a multicenter validation study. N Engl J Med 339(14):941–946

    Article  PubMed  CAS  Google Scholar 

  17. Kuhn T, Bembenek A, Buchels H, Decker T, Dunst J, Mullerleile U, Munz DL, Ostertag H, Sautter-Bihl ML, Schirrmeister H, Tulusan AH, Untch M, Winzer KJ, Wittekind C (2004) Sentinel node biopsy in breast cancer. Nuklearmedizin 43(1):4–9

    PubMed  CAS  Google Scholar 

  18. Macmillan RD, Barbera D, Hadjiminas DJ, Rampaul RS, Lee AH, Pinder SE, Ellis IO, Blamey RW, Geraghty JG (2001) Sentinel node biopsy for breast cancer may have little to offer four-node-samplers. Results of a prospective comparison study. Eur J Cancer 37(9):1076–1080

    Article  PubMed  CAS  Google Scholar 

  19. Mansel RE, Goyal A (2004) European studies on breast lymphatic mapping. Semin Oncol 31(3):304–310

    Article  PubMed  Google Scholar 

  20. Moran MS, Haffty BG (2002) Local-regional breast cancer recurrence: prognostic groups based on patterns of failure. Breast J 8(2):81–87

    Article  PubMed  Google Scholar 

  21. Murray KL, Lambah PA, Anderson TJ, Dixon JM (2002) Occult lymph node metastases in patients with “node negative” breast carcinoma treated with conservation surgery and axillary node sample and who subsequently developed axillary recurrence. Breast 11(3):249–251

    Article  PubMed  CAS  Google Scholar 

  22. Newman LA, Hunt KK, Buchholz T, Kuerer HM, Vlastos G, Mirza N, Ames FC, Ross MI, Singletary SE (2000) Presentation, management and outcome of axillary recurrence from breast cancer. Am J Surg 180(4):252–256

    Article  PubMed  CAS  Google Scholar 

  23. Palesty JA, Foster JM, Hurd TC, Watroba N, Rezaishiraz H, Edge SB (2006) Axillary recurrence in women with a negative sentinel lymph node and no axillary dissection in breast cancer. J Surg Oncol 93(2):129–132

    Article  PubMed  Google Scholar 

  24. Ponzone R, Biglia N, Maggiorotto F, Kubatzki F, Elia O, De Rosa G, Sismondi P (2003) Sentinel node dissection as definitive treatment for node negative breast cancer patients. Eur J Surg Oncol 29(9):703–706

    Article  PubMed  CAS  Google Scholar 

  25. Recht A, Pierce SM, Abner A, Vicini F, Osteen RT, Love SM, Silver B, Harris JR (1991) Regional nodal failure after conservative surgery and radiotherapy for early-stage breast carcinoma. J Clin Oncol 9(6):988–996

    PubMed  CAS  Google Scholar 

  26. Reitsamer R, Peintinger F, Prokop E, Rettenbacher L, Menzel C (2004) 200 Sentinel lymph node biopsies without axillary lymph node dissection—no axillary recurrences after a 3-year follow-up. Br J Cancer 90(8):1551–1554

    Article  PubMed  CAS  Google Scholar 

  27. Roumen RM, Kuijt GP, Liem IH, van Beek MW (2001) Treatment of 100 patients with sentinel node-negative breast cancer without further axillary dissection. Br J Surg 88(12):1639–1643

    Article  PubMed  CAS  Google Scholar 

  28. Sinha PS, Thrush S, Bendall S, Bates T (2002) Does radical surgery to the axilla give a survival advantage in more severe breast cancer? Eur J Cancer 38(11):1474–1477

    Article  PubMed  CAS  Google Scholar 

  29. Soni NK, Spillane AJ (2005) Experience of sentinel node biopsy alone in early breast cancer without further axillary dissection in patients with negative sentinel node. ANZ J Surg 75(5):292–299

    Article  PubMed  Google Scholar 

  30. Torrenga H, Fabry H, van der Sijp JR, van Diest PJ, Pijpers R, Meijer S (2004) Omitting axillary lymph node dissection in sentinel node negative breast cancer patients is safe: a long term follow-up analysis. J Surg Oncol 88(1):4–7

    Article  PubMed  Google Scholar 

  31. Turner RR, Ollila DW, Krasne DL, Giuliano AE (1997) Histopathologic validation of the sentinel lymph node hypothesis for breast carcinoma. Ann Surg 226(3):271–276

    Article  PubMed  CAS  Google Scholar 

  32. Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bedoni M, Costa A, De Cicco C, Geraghty JG, Luini A, Sacchini V, Veronesi P (1997) Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet 349(9069):1864–1867

    Article  PubMed  CAS  Google Scholar 

  33. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P, Renne G, De Cicco C, De Lucia F, Gennari R (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349(6):546–553

    Article  PubMed  Google Scholar 

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Correspondence to Darius Dian.

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Darius Dian and Julia Straub contributed equally to this manuscript.

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Dian, D., Straub, J., Scholz, C. et al. Influencing factors for regional lymph node recurrence of breast cancer. Arch Gynecol Obstet 277, 127–134 (2008). https://doi.org/10.1007/s00404-007-0432-3

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  • DOI: https://doi.org/10.1007/s00404-007-0432-3

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