Second Biopsy of Axillary Sentinel Lymph Node for Reappearing Breast Cancer After Previous Sentinel Lymph Node Biopsy
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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.
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.
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.
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.
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- Second Biopsy of Axillary Sentinel Lymph Node for Reappearing Breast Cancer After Previous Sentinel Lymph Node Biopsy
Annals of Surgical Oncology
Volume 12, Issue 11 , pp 895-899
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Breast cancer
- Axillary sentinel lymph node biopsy
- Reoperative biopsy
- Second biopsy
- Reappearing breast cancer
- Industry Sectors
- Author Affiliations
- 1. Division of Breast Surgery, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy
- 2. Division of Nuclear Medicine, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy
- 3. Division of Pathology and Laboratory Medicine, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy
- 4. University of Milan School of Medicine, Milan, Italy
- 5. Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy