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Original Article |
1 Department of Surgery, Baptist Medical Center, 2105 E. South Boulevard, Montgomery, Alabama 36116
2 Department of Radiology, Baptist Medical Center, 2105 E. South Boulevard, Montgomery, Alabama 36116
Correspondence: Address correspondence and reprint requests to: Howard C. Snider, Jr., MD; E-mail: hsnidermd{at}pol.net.
Background: Sentinel node biopsy (SNB) for breast cancer has a false-negative rate of approximately 5%. Initial reports of follow-up show lower axillary recurrence rates than expected. We performed axillary ultrasonography to determine whether occult recurrences could be detected.
Methods: In a community hospital setting, 289 patients who had SNB for breast cancer in a single surgeon’s practice underwent axillary examination by the surgeon followed by axillary ultrasonography by a dedicated breast radiologist. Ultrasonography was performed one time from 4 to 79 months (median, 25 months) after surgery. Five patients with suspicious nodes had ultrasound-guided fine-needle aspiration, and one had a core biopsy.
Results: No patient had suspicious nodes on clinical examination. Only six patients had ultrasound findings that warranted intervention. Five patients had benign cytological characteristics, and one had a benign core biopsy result. No evidence of axillary recurrence was found in any patient.
Conclusions: Axillary ultrasonography did not detect occult metastases in any patient and is not recommended for routine follow-up after SNB. The lack of ultrasound evidence of metastasis suggests that the recurrence rate is likely to remain low.
Key Words: Sentinel node • Ultrasound • Axilla • Breast cancer
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