Axillary recurrence rate 5 years after negative sentinel node biopsy for breast cancer

Background: Sentinel lymph node (SLN) biopsy has replaced axillary lymph node dissection (ALND) as the standard axillary staging procedure in breast cancer. Follow‐up studies in SLN‐negative women treated without ALND report low rates of axillary recurrence, but most studies have short follow‐up, and few are multicentre studies. Methods: Between September 2000 and January 2004, patients who were SLN‐negative and did not have ALND were included in a prospective cohort. Kaplan‐Meier estimates were used to analyse the rates of axillary recurrence and survival. The risk of axillary recurrence was also compared in centres with high and low experience with the SLN biopsy (SLNB) technique. Results: A total of 2195 patients with 2216 breast tumours were followed for a median of 65 months. Isolated axillary recurrence was diagnosed in 1·0 per cent of patients. The event‐free 5‐year survival rate was 88·8 per cent and the overall 5‐year survival rate 93·1 per cent. There was no difference in recurrence rates between centres contributing fewer than 150 SLNB procedures to the cohort and centres contributing 150 or more procedures. Conclusion: This study confirmed the low risk of axillary recurrence 5 years after SLNB for breast cancer without ALND. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Still a safe procedure