TY - JOUR
T1 - Stage migration with sentinel node biopsy in breast cancer
AU - Layeequr Rahman, Rakhshanda
AU - Siegel, Eric
AU - Boneti, Cristiano
AU - Ingram, Malene
AU - Kepple, Julie
AU - Henry-Tillman, Ronda S.
AU - Klimberg, V. Suzanne
N1 - Funding Information:
R.L.R. and J.K. were supported by the Susan G. Komen Breast Cancer Interdisciplinary Fellowship, and by the Virginia Clinton Kelley/Fashion Footwear Association of New York Breast Cancer Research Fellowship.
PY - 2009/4
Y1 - 2009/4
N2 - Background: Axillary staging provides the single most important piece of prognostic information in breast cancer patients. This retrospective study was performed to document the phenomenon of stage migration. Methods: Of 392 patients, 5 (1%) failed identification of sentinel lymph nodes (SLNs) and therefore underwent axillary lymph node dissection (ALND). Four patients (80%) had metastatic lymph nodes, 302 (77%) patients had negative SLNs, 47 (15%) underwent ALND, 85 (22%) had positive SLNs, 11 (13%) received adjuvant radiation treatment to the axilla, and 74 (87%) underwent completion ALND. Results: The median (quartiles) follow-up period was 29 months (19-46 mo). Twenty of 392 (5%) patients had disease relapse; 2 of which were local (.5%) and the rest were systemic. Earlier relapse was related significantly to lymph node status, tumor grade, and tumor size. SLN-negative patients who did not receive ALND had a relapse rate of 2.3% (6 of 256) compared with 0% in those who were truly negative based on confirmatory ALND. SLN-positive patients who did not receive ALND had a 9% (1 of 11) relapse rate. Discussion: The stage-matched pattern of relapse between SLN biopsy and ALND patients revealed lower relapse rates in SLN biopsy-staged patients, documenting the stage migration phenomenon.
AB - Background: Axillary staging provides the single most important piece of prognostic information in breast cancer patients. This retrospective study was performed to document the phenomenon of stage migration. Methods: Of 392 patients, 5 (1%) failed identification of sentinel lymph nodes (SLNs) and therefore underwent axillary lymph node dissection (ALND). Four patients (80%) had metastatic lymph nodes, 302 (77%) patients had negative SLNs, 47 (15%) underwent ALND, 85 (22%) had positive SLNs, 11 (13%) received adjuvant radiation treatment to the axilla, and 74 (87%) underwent completion ALND. Results: The median (quartiles) follow-up period was 29 months (19-46 mo). Twenty of 392 (5%) patients had disease relapse; 2 of which were local (.5%) and the rest were systemic. Earlier relapse was related significantly to lymph node status, tumor grade, and tumor size. SLN-negative patients who did not receive ALND had a relapse rate of 2.3% (6 of 256) compared with 0% in those who were truly negative based on confirmatory ALND. SLN-positive patients who did not receive ALND had a 9% (1 of 11) relapse rate. Discussion: The stage-matched pattern of relapse between SLN biopsy and ALND patients revealed lower relapse rates in SLN biopsy-staged patients, documenting the stage migration phenomenon.
KW - Breast cancer
KW - Sentinel lymph node
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U2 - 10.1016/j.amjsurg.2008.07.052
DO - 10.1016/j.amjsurg.2008.07.052
M3 - Article
C2 - 19178897
AN - SCOPUS:62949220008
SN - 0002-9610
VL - 197
SP - 491
EP - 496
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 4
ER -