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Outcomes After Localized Axillary Node Recurrence in Breast Cancer

From the Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Correspondence: Address correspondence and reprint requests to: D. R. McCready, MD, MSc, Department of Surgical Oncology, Princess Margaret Hospital, University of Toronto, 3-130, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9; Fax: 416-946-6590; E-mail: David.McCready{at}uhn.on.ca

Background: Localized axillary recurrence (LAR) is an uncommon event. It is estimated to occur in 0.5% to 3% of patients when adequate axillary surgery has been performed. Although relatively sparse data exist on the outcome of patients with LAR, in the era of sentinel node biopsy (SNB) these data may have increased relevance. This study assesses the survival outcomes in these patients.

Methods: A retrospective chart review was completed. Patient age, tumor size, pathology, receptor status, and treatment of the primary breast carcinoma were reviewed. Axillary recurrence, treatment, and overall survival data were collected.

Results: Fifteen patients were identified with LAR that developed at a median of 77 months after their initial dissection. At the time of treatment for their LAR, all patients had completion axillary clearance and six also had a concurrent completion mastectomy. Further adjuvant treatment was individualized. Five patients (33%) have died, including all patients (3) who developed a LAR within 2 years of their initial breast cancer presentation. Ten-year overall survival is 56%.

Conclusion: Our experience suggests early (<24 months) LAR is indicative of a poor prognosis. With multimodal treatment, ten-year overall survival is 56%.

Key Words: Breast cancer • Axillary recurrence • Survival • Surgery

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