Objective:
SLNB procedure is developed as an alternative to ALND in surgical therapy of breast cancer and is a safe staging method with low morbidity. Our objective in the present study is to determine relapse rates in long-term follow up and the affecting factors in patients who underwent breast-conserving surgery (BCS) + SLNB.
Material and Methods:
In this study 171 patients treated with BCS and SLNB between 2006 and 2011, for early stage breast cancer were included. In 62 of 171 patients, SLN was positive and Level 1-2 axillary dissection was applied to them. Two group of patients who had SLNB (-) and (+) have been followed up clinically and radiologically for averagely 36 months. Locoregional recurrence and metastasis rates were compared for both groups. In the lights of literature, age of patients, menopausal situation, localization of tumor, histology of tumor, size of SLN, estrogen-progesterone receptor and C erb-B2 positivity, grade of tumor, existence of extensive intraductal component, size of tumor and lymphovascular invasion were examined as possible factors that may affect rates of axillary lymph node positivity and local-axillary relapse.
Results:
171 patients were followed up 36 months. In the SLNB (-) group only one patient had axillary relapse 25 months after primary surgery. Relapse rate was 0.92 %. None of SLNB (-) patients had local relapse. In the SLNB (+) group, patients underwent ALND and no one had axillary relapse, 4 had local relapse (5.84 %). 18 patients had distant metastasis. SLNB (-) patients were significantly less likely to develop local relapse. There was no significant difference in axillary relapse and distant metastasis for both groups. Size of tumor, existence of LVI, stage of disease and size of SLN were the factors affecting SLN positivity.
Conclusion:
SLNB is as reliable as ALND when locoregional relapse and distant metastasis is concerned.
Keywords: breast cancer, sentinel lymph node biopsy, locoregional relapse