Clinical axillary recurrence in breast cancer patients after a negative sentinel node biopsy

Background: The purpose of this study was to determine the axillary recurrence rate in breast cancer patients with a negative sentinel lymph node who did not have an axillary node dissection. Methods: Sentinel lymphadenectomy for breast cancer patients, without axillary node dissection if the node was negative, was introduced in 1998 at our institution. This study includes those women with a negative sentinel lymph node. Adjuvant chemotherapy was administered based on primary tumor characteristics. If breast radiotherapy was used, no attempt was made to include the axilla. Results: From January 1998 to December 2001, 206 patients (208 breast cancers) had a negative sentinel lymph node. The median age at diagnosis was 56 years and median tumor size was 1.2 cm. With a median follow-up of 26 months, there have been 3 axillary recurrences with a clinical sentinel lymph node false negative rate of 1.4%. Conclusions: In this study, the clinical false negative rate of a sentinel lymph node biopsy is 1.4%. Our study provides further evidence supporting the use of sentinel lymphadenectomy in women with breast cancer.