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Second Axillary Sentinel Lymph Node Biopsy for Breast Tumor Recurrence: Experience of the European Institute of Oncology

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

This retrospective study aimed to determine the feasibility, accuracy, and recurrence rates of lymphoscintigraphy and the new sentinel lymph node biopsy (SLNB) for patients with ipsilateral breast tumor recurrences who were treated previously with conservative surgery and had negative SLNB results.

Methods

The study was conducted at the European Institute of Oncology in Milan and included 212 patients with the diagnosis of operable local breast cancer recurrence. They had been treated previously with conservative surgery and showed negative SLNB results. They subsequently underwent additional breast surgery and a second SLNB between May 2001 and December 2011.

Results

Preoperative lymphoscintigraphy demonstrated at least one new axillary sentinel lymph node (SLN) in 207 patients (97.7 %), whereas no drainage was observed in five patients (2.3 %). One or more SLNs were surgically removed from 196 of the 207 patients. Isolation of SLNs from the remaining 11 patients could not be accomplished. The success rate for the SLNB was 92.5 %. Extra-axillary drainage pathways were visualized in 17 patients (8 %). The annual axillary recurrence rate after a median follow-up period of 48 months was 0.8 %, and the cumulative incidence of axillary recurrence at 5 years was 3.9 %.

Conclusions

A second SLNB should be considered for patients with operable local breast tumor recurrence who underwent conservative surgery and had negative SLNB results. The procedure is technically feasible and accurate for selected patients.

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Author information

Authors and Affiliations

  1. Division of Breast Surgery, European Institute of Oncology, Milan, Italy

    M. Intra MD, J. Vila MD, A. Toesca MD, O. Gentilini MD, V. Galimberti MD, P. Veronesi MD, A. Luini MD & D. Mattar MD

  2. Division of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy

    G. Viale MD

  3. University of Milan School of Medicine, Milan, Italy

    G. Viale MD & P. Veronesi MD

  4. Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy

    C. M. Grana MD

  5. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy

    N. Rotmensz MSc & V. Bagnardi MSc

  6. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy

    V. Bagnardi MSc

  7. Division of Medical Senology, European Institute of Oncology, Milan, Italy

    M. Colleoni MD

Authors
  1. M. Intra MD
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  2. G. Viale MD
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  3. J. Vila MD
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  4. C. M. Grana MD
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  5. A. Toesca MD
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  6. O. Gentilini MD
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  7. V. Galimberti MD
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  8. P. Veronesi MD
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  9. A. Luini MD
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  10. N. Rotmensz MSc
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  11. V. Bagnardi MSc
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  12. D. Mattar MD
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  13. M. Colleoni MD
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Corresponding author

Correspondence to M. Intra MD.

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Intra, M., Viale, G., Vila, J. et al. Second Axillary Sentinel Lymph Node Biopsy for Breast Tumor Recurrence: Experience of the European Institute of Oncology. Ann Surg Oncol 22, 2372–2377 (2015). https://doi.org/10.1245/s10434-014-4282-5

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  • DOI: https://doi.org/10.1245/s10434-014-4282-5

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