Follow-up Results of Sentinel Lymph Node Biopsy using the Dye-Only Method for Breast Cancer

To demonstrate the validity of sentinel lymph node biopsy (SLNB) using the indocyanine green dye method (dye only method), we compared the survival of breast cancer patients negative to SLNB without axillary lymph node dissection (ALND) (SLNB group) to that of lymph node-negative patients undergoing ALND (ALND group). We studied a total of 174 patients with T1-2N0 invasive breast cancer diagnosed at our university hospital clinical department between 2000 and 2008, with follow-up till 31 December 2009, retrospectively. The SLNB group consisted of 108 SLNB-negative women without additional ALND (median follow-up, 25 months), diagnosed between May 2005 and 2008. The ALND group consisted of 66 axillary lymph node-negative women (median follow-up, 75 months) treated with ALND between 2000 and April 2005. SLNB was performed during operation by periareolar injection using indocyanine green. All sentinel lymph nodes were examined using the largest section along the major axis, and permanent sections were stained with hematoxylin and eosin. In the SLNB group, no patients developed axillary recurrence during the 25-month median follow-up. The 4.5-year distant disease free survival and overall survival rates were 90.9% and 91.9%, respectively. The survival rate in the SLNB group was equivalent to that in the ALND group. This suggests that SLNB with the dye only method can safely replace ALND as the procedure of choice for axillary staging in breast cancer patients with a clinically negative axilla.