Regional recurrence in the era of sentinel lymph node biopsy

Abstract Background The incidence of all-location regional recurrence after sentinel lymph node biopsy is not well documented. This study attempts to identify risk factors. Methods A prospectively maintained database was queried to identify patients with a regional recurrence of breast cancer after a first operation for invasive unilateral breast cancer. Patients with regional recurrence were compared with those alive and disease free at 5 years. Results Twenty-one of 1,060 patients (2%) experienced a regional recurrence. Most patients (95%) underwent sentinel lymph node biopsy as their axillary staging. Those with regional recurrences had larger tumors ( P < .001), higher stage disease ( P < .001), more estrogen receptor– and triple-negative breast cancers ( P < .001), and more positive lymph nodes ( P = .007). Mastectomy ( P = .001) and receipt of neoadjuvant and/or chemotherapy ( P < .001) were more common among those with regional recurrences. Conclusions Regional recurrence of breast cancer occurs infrequently. Risk factors include high-risk cancers, higher stage at presentation, nodal involvement, and need for therapies reflecting higher risk biology.