© 2004 Foundation for Promotion of Cancer Research
Prognosis of Breast Cancer Patients Treated with Sentinel Node Biopsy in Japan
1 Breast Surgery Division and 2 Radiology Division, National Cancer Center Hospital East, 3 Pathology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, and 4 Head and Neck Surgery Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
For reprints and all correspondence: Shigeru Imoto, Breast Surgery Division, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. E-mail: simoto{at}east.ncc.go.jp
Received April 16, 2004; accepted May 20, 2004
Background: Sentinel node biopsy predicts accurate pathological nodal staging. The survival of node-negative breast cancer patients should be evaluated between the patients treated with sentinel node biopsy alone and those treated with axillary lymph node dissection.
Methods: Ninety-seven patients with negative axillary nodes underwent sentinel node biopsy immediately followed by axillary lymph node dissection between January 1998 and June 1999 (the ALND group). Since then, if sentinel lymph nodes were negative on the frozen-section diagnosis, 112 patients underwent sentinel node biopsy alone without axillary lymph node dissection between July 1999 and December 2000 (the SNB group). We retrospectively observed the outcome of the two study groups.
Results: Median follow-up was 52 months in all patients. Relapse-free survival rates at 3 years in the ALND and SNB groups were 94% and 93%, respectively. Five of the 112 patients in the SNB group had overt axillary metastases. Three of them with axillary metastases alone were treated with delayed axillary lymph node dissection. These three patients have been free of other events for 3 years after local salvage treatment.
Conclusions: Sentinel node biopsy will emerge as a standard method to diagnose axillary nodal staging for clinically node-negative breast cancer patients.
Key Words: breast cancer • sentinel node biopsy • axillary lymph node dissection • prognosis
Abbreviations: ALND, axillary lymph node dissection • CT, chemotherapy • ER, estrogen receptor • HE, hematoxylin–eosin • IDC, invasive ductal carcinoma • IHC, immunohistochemistry • ILC, invasive lobular carcinoma • NIDC, non-invasive ductal carcinoma • Ps, parasternal • PR, progesterone receptor • SLNs, sentinel lymph nodes • SNB, sentinel node biopsy • Sc, supraclavicular • TAM, tamoxifen • 99mTc, technetium 99m-labeled • UFT, Uracil plus Tegafur
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