Introduction: Sentinel node biopsy is currently the standard of care for axillary treatment of clinically axillary node-negative breast cancer. In this report, we describe a case of axillary lymph node recurrence 10 years after surgery in a patient with a negative sentinel node biopsy at the time of initial surgery.

Presentation of case: The patient was a 49-year-old premenopausal woman. She had undergone left mastectomy and sentinel node biopsy (dye method only) for left breast cancer (T3N0M0) 10 years earlier. Ten years after surgery, an enlarged left axillary lymph node measuring 2 cm in diameter was noted on ultrasound examination. Left axillary lymph node dissection was performed. Postoperative histopathology showed that the tumor cells were negative for E-cadherin and that the patient had invasive lobular carcinoma.

Discussion: A second sentinel node might have been missed considering that the sentinel node was detected by the dye method alone, without use of the isotope method, which might have enabled detection of another sentinel node. Observation of the axillary lymph nodes is essential for follow-up after sentinel node biopsy.

Conclusion: After sentinel node biopsy, postoperative follow-up imaging studies should include ultrasonography to check for enlarged lymph nodes.

Breast cancer, Sentinel lymph node, False negative, Late recurrence