Annals of Surgical Oncology

, Volume 12, Issue 11, pp 895–899

Second Biopsy of Axillary Sentinel Lymph Node for Reappearing Breast Cancer After Previous Sentinel Lymph Node Biopsy

  • Mattia Intra
  • Giuseppe Trifirò
  • Giuseppe Viale
  • Nicole Rotmensz
  • Oreste D. Gentilini
  • Javier Soteldo
  • Viviana Galimberti
  • Paolo Veronesi
  • Alberto Luini
  • Giovanni Paganelli
  • Umberto Veronesi
Original Articles

DOI: 10.1245/ASO.2005.10.018

Cite this article as:
Intra, M., Trifirò, G., Viale, G. et al. Ann Surg Oncol (2005) 12: 895. doi:10.1245/ASO.2005.10.018

Abstract

Background

Sentinel lymph node biopsy (SLNB) is a safe and accurate axillary staging procedure for patients with primary operable breast cancer. An increasing proportion of these patients undergo breast-conserving surgery, and 5% to 15% will develop local relapses that necessitate reoperation. Although a previous SLNB is often considered a contraindication for a subsequent SLNB, few data support this concern.

Methods

Between January 2000 and June 2004, 79 patients who were previously treated at our institution with breast-conserving surgery and who had a negative SLNB for early breast cancer developed, during follow-up, local recurrence that was amenable to reoperation. Eighteen of these patients were offered a second SLNB because of a clinically negative axillary status an average of 26.1 months after the primary event.

Results

In all 18 patients (7 with ductal carcinoma-in-situ and 11 with invasive recurrences), preoperative lymphoscintigraphy showed an axillary sentinel lymph node, with a preoperative identification rate of 100%, and 1 or more SLNs (an average of 1.3 per patient) were surgically removed. Sentinel lymph node metastases were detected in two patients with invasive recurrence, and a complete axillary dissection followed. At a median follow up of 12.7 months, no axillary recurrences have occurred in patients who did not undergo axillary dissection.

Conclusions

Second SLNB after previous SLNB is technically feasible and likely effective in selected breast cancer patients. A larger population and longer follow-up are necessary to confirm these preliminary data.

Keywords

Breast cancer Axillary sentinel lymph node biopsy Reoperative biopsy  Second biopsy Reappearing breast cancer Recurrence 

Copyright information

© The Society of Surgical Oncology, Inc. 2005

Authors and Affiliations

  • Mattia Intra
    • 1
  • Giuseppe Trifirò
    • 2
  • Giuseppe Viale
    • 3
    • 4
  • Nicole Rotmensz
    • 5
  • Oreste D. Gentilini
    • 1
  • Javier Soteldo
    • 1
  • Viviana Galimberti
    • 1
  • Paolo Veronesi
    • 1
    • 4
  • Alberto Luini
    • 1
  • Giovanni Paganelli
    • 2
  • Umberto Veronesi
    • 1
  1. 1.Division of Breast SurgeryEuropean Institute of OncologyItaly
  2. 2.Division of Nuclear MedicineEuropean Institute of OncologyItaly
  3. 3.Division of Pathology and Laboratory MedicineEuropean Institute of OncologyItaly
  4. 4.University of Milan School of MedicineItaly
  5. 5.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyItaly

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