Outcome of Selected Breast Cancer Patients With Micrometastasis or Isolated Tumor Cells in Sentinel Node Biopsy and No Completion Axillary Lymph Node Dissection

Background and Objectives: Axillary lymph node dissection (ALND) is the standard of care in patients with tumor-positive sentinel nodes (SN). However, approximately half of these patients do not have additional metastases in their axilla and therefore do not benefit from completion ALND. Our aim was to examine the outcome of highly selected breast cancer patients with tumor-positive SN without completion ALND. Methods: Altogether 48 patients with tumor-positive SN without ALND were included in this study. Twenty-two patients had micrometastasis and 26 had isolated tumor cells (ITC) in their sentinel node biopsy. The median follow-up time was 37 months (range 9-78). Results: No axillary recurrences occurred during the follow-up. One patient had a local recurrence. Distant metastases as the first event were observed in two patients. One of them died in breast cancer. Nine patients died from intercurrent causes. Conclusions: Omitting ALND seems safe in selected breast cancer patients with SN micrometastasis or ITC. J. Surg. Oncol. 2010;102:215-219. (C) 2010 Wiley-Liss, Inc.