Regional Recurrence Risk Following a Negative Sentinel Node Procedure Does Not Approximate the False-Negative Rate of the Sentinel Node Procedure in Breast Cancer Patients Not Receiving Radiotherapy or Systemic Treatment

Journal Article · Fri Feb 15 04:00:00 EST 2019 · Annals of Surgical Oncology (Online)

DOI:https://doi.org/10.1245/S10434-018-6940-5· OSTI ID:22927887

Steenhoven, Julia E. C. van; Aalders, Kim C. ^[1]; Schreuder, Kay ^[2]; Burgmans, Josephina P. J. ^[1]; Siesling, Sabine ^[2]; Elias, Sjoerd ^[3]; Dalen, Thijs van ^[1]

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1. Diakonessenhuis Utrecht, Department of Surgery (Netherlands)
2. Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research (Netherlands)
3. University Medical Center Utrecht, Department of Epidemiology, Julius Center for Health Sciences and Primary Care (Netherlands)

Background: Although the false-negative rate of the sentinel lymph node biopsy (SLNB) in breast cancer patients is 5–7%, reported regional recurrence (RR) rates after negative SLNB are much lower. Adjuvant treatment modalities probably contribute to this discrepancy. This study assessed the 5-year RR risk after a negative SLNB in the subset of patients who underwent breast amputation without radiotherapy or any adjuvant treatment. Methods: All patients operated for primary unilateral invasive breast cancer between 2005 and 2008 were identified in the Netherlands Cancer Registry. Patients with a negative SLNB who underwent breast amputation and who were not treated with axillary lymph node dissection, radiotherapy, or any adjuvant systemic treatment were selected. The cumulative 5-year RR rate was estimated by Kaplan–Meier analysis. Results: A total of 13,452 patients were surgically treated for primary breast cancer and had a negative SLNB, and 2012 patients fulfilled the selection criteria. Thirty-eight RRs occurred during follow-up. Multifocal disease was associated with a higher risk of developing RR (P = 0.04). The median time to RR was 27 months and was significantly shorter in patients with estrogen receptor-negative (ER−) breast cancer (9.5 months; P = 0.003). The 5-year RR rate was 2.4% in the study population compared with 1.1% in the remainder of 11,440 SLNB-negative patients (P = 0.0002). Conclusions: Excluding the effect of radiotherapy and systemic treatment resulted in a twofold 5-year RR risk in breast cancer patients with a tumor-free SLNB. This 5-year RR rate was still much lower than the reported false-negative rate of the SLNB procedure.

• OSTI ID: 22927887
• Journal Information: Annals of Surgical Oncology (Online), Journal Name: Annals of Surgical Oncology (Online) Journal Issue: 2 Vol. 26; ISSN 1534-4681
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOPSY
ESTROGENS
LYMPH NODES
MAMMARY GLANDS
NEOPLASMS
NETHERLANDS
PATIENTS
RADIOTHERAPY
SURGERY