Axillary metastases in breast cancer patients with negative sentinel nodes: A follow-up of 3548 cases

PremisesSentinel node biopsy (SNB) in patients with breast carcinoma accurately predicts the axillary node status. However, in some 4–7% of patients with negative sentinel nodes, the remaining axillary nodes harbour cancer cells.ObjectiveOur purpose was the long-term observation of a large number of patients who did not receive axillary dissection after a negative sentinel node biopsy, in order to evaluate the incidence of overt axillary metastases.MethodsPatients (3548) treated from 1996 to 2004, with negative sentinel nodes not submitted to axillary dissection, were followed up to 11 years with a median follow-up of 48 months.ResultsThree hundred and sixteen unfavourable events occurred among the 3548 patients, 196 of which (5.5%) related to primary breast carcinoma. Thirty one cases of overt axillary metastases were found (0.9%): they received total axillary dissection and 27 of them are at present alive and well. The 5-year overall survival rate of the whole series was 98%.ConclusionsPatients with negative sentinel node biopsy not submitted to axillary dissection show, at follow-up, a rate of overt axillary metastases lower than expected.