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Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer

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

Abstract

Background

The aim of this study was to investigate the use of sentinel lymph node dissection (SLND) in the treatment of patients with locally recurrent breast cancer.

Methods

A total of 147 patients with locally recurrent breast cancer were included from five different breast surgery departments in Denmark. Data on previous breast and axillary surgery, adjuvant treatment, second operation in the breast and axilla, and lymphoscintigraphy were collected retrospectively from the original patient files.

Results

SLND after recurrence (SLNDAR) was successful in 72 of 144 patients (50 %). The detection rate was significantly higher after previous SLND (66 %) compared with previous ALND (34 %) [p = 0.0001]. Thirty-seven patients (51 %) who had previous SLND had a negative sentinel node. These patients could be spared an ALND. Six patients (8 %) who had a previous ALND had a metastatic sentinel node at recurrence; 17 % of patients had a sentinel node located outside the ipsilateral axilla; and eight patients with negative sentinel node at SLNDAR underwent completion ALND. None of these patients had metastases at completion ALND, corresponding to a false negative rate of 0 %.

Conclusions

SLNDAR seems to be a feasible procedure in locally recurrent breast cancer and can spare a clinically significant number of patients an unnecessary ALND and the following risk of sequelae. In patients who had previous ALND, SLNDAR identified metastases that would have been overlooked following the current guidelines. A large proportion of patients had aberrant drainage, suggesting a need for lymphoscintigraphy.

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Conflict of interest

Charlotte Caspara Uth, Mette Haulund Christensen, Mette Holmqvist Oldenbourg, Christina Kjær, Jens Peter Garne, Dorthe Teilum, Niels Kroman, and Tove Filtenborg Tvedskov have no commercial interest in the subject of the study and have received no financial or material support of any source.

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Authors and Affiliations

  1. Brystkirurgisk klinik, Rigshospitalet, Copenhagen, Denmark

    Charlotte Caspara Uth MD, Dorthe Teilum MD, Niels Kroman MD, Dr.Med. & Tove Filtenborg Tvedskov MD, PhD

  2. Brystkirurgisk afdeling, Herlev Hospital, Herlev, Denmark

    Mette Haulund Christensen MD

  3. Mammakirurgisk afdeling, Ringsted Sygehus, Ringsted, Denmark

    Mette Holmqvist Oldenbourg MD

  4. Mammacenteret, Vejle Sygehus, Vejle, Denmark

    Christina Kjær MD

  5. Mammakirurgisk afdeling, Aalborg Universitets Hospital, Aalborg, Denmark

    Jens Peter Garne MD, Dr.Med.

Authors
  1. Charlotte Caspara Uth MD
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  2. Mette Haulund Christensen MD
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  3. Mette Holmqvist Oldenbourg MD
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  4. Christina Kjær MD
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  5. Jens Peter Garne MD, Dr.Med.
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  6. Dorthe Teilum MD
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  7. Niels Kroman MD, Dr.Med.
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  8. Tove Filtenborg Tvedskov MD, PhD
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Corresponding author

Correspondence to Tove Filtenborg Tvedskov MD, PhD.

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Uth, C.C., Christensen, M.H., Oldenbourg, M.H. et al. Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer . Ann Surg Oncol 22, 2526–2531 (2015). https://doi.org/10.1245/s10434-014-4338-6

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  • DOI: https://doi.org/10.1245/s10434-014-4338-6

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