Abstract
Background. Sentinel lymph node biopsy (SLNB) is an accurate alternative to complete axillary lymph node dissection (ALND) in clinically node-negative breast cancer patients. A previous breast biopsy has been considered a relative contraindication to SLNB. We examined the accuracy of SLNB by following the axillary relapses after the procedure in patients who had undergone a breast biopsy before SLNB.
Patients and Methods. Up to December 2003, 4351 patients with the diagnosis of invasive breast cancer underwent SLNB at the European Institute of Oncology. Already, 543 of these patients had undergone a breast biopsy; from June 1997 to January 2004, these patients received SLNB by lymphoscintigraphy performed on the biopsy area. We followed these patients with a clinical assessment every 6 months and instrumental examinations every year, particularly focusing on the research of axillary relapse of disease.
Results. In 70.4% of cases, the sentinel node was negative, and only three cases underwent further axillary dissection. The sentinel node was identified in 99% of cases and this was the only positive node in 61.5% of cases with positive axillary nodes. The median follow-up was 2 years; 4 nodal recurrences were observed: 3 axillary lymph node relapses and 1 loco-regional.
Conclusions. SLNB accuracy after a previous breast biopsy is comparable with the results obtained in validation studies. SLNB after a previous breast biopsy can be considered a standard procedure. Lymphoscintigraphy identifies the sentinel node in 99% of patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
U Veronesi G Paganelli V Galimberti (1997) ArticleTitleSentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes Lancet 349 1864–1867 Occurrence Handle10.1016/S0140-6736(97)01004-0 Occurrence Handle1:STN:280:ByiA28%2FnvFA%3D Occurrence Handle9217757
U Veronesi G Paganelli G Viale (2003) ArticleTitleA randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer N Engl J Med 349 546–553 Occurrence Handle10.1056/NEJMoa012782 Occurrence Handle12904519
Greco M, Crippa F, Agresti R: Axillary lymph node staging in breast cancer by 2-fluoro-2-deoxy-D-glucose-positron emission tomography: clinical evaluation and alternative management.
G Zornoza MJ Garcia-Velloso J Sola FM Regueira L Pina C Beorlegui (2004) ArticleTitle18F-FDG PET complemented with sentinel lymph node biopsy in the detection of axillary involvement in breast cancer. Eur J Surg Oncol 30 15–19
S Zurrida R Orecchia V Galimberti (2002) ArticleTitleAxillary radiotherapy instead of axillary dissection: a randomized trial. Italian Oncological Senology Group Ann Surg Oncol 9 117–119
G Trifiro G Viale O Gentilini (2004) ArticleTitleSentinel node detection in pre-operative axillary staging Eur J Nucl Med Mol Imaging 1 S46–S55
SH Estourgie OE Nieweg RA Olmos EJ Rutgers BB Kroon (2004) ArticleTitleLymphatic drainage patterns from the breast Ann Surg 239 232–237
R Layeeque R Henry-Tillman S Korourian R Kass VS Klimberg (2003) ArticleTitleSubareolar sentinel node biopsy for multiple breast cancers. Am J Surg 186 730–735
SK Boolbol JV Fey PI Borgen (2001) ArticleTitleIntradermal isotope injection: a highly accurate method of lymphatic mapping in breast carcinoma Ann Surg Oncol 8 20–24
JJ Albertini GH Lyman C Cox (1996) ArticleTitleLymphatic mapping and sentinel node biopsy in the patient with breast cancer JAMA 276 1818–1822 Occurrence Handle10.1001/jama.276.22.1818 Occurrence Handle1:STN:280:ByiC3c3ms1Y%3D Occurrence Handle8946902
PJ Borgstein R Pijpers EF Comans (1998) ArticleTitleSentinel Lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection J Am Coll Surg 186 275–283 Occurrence Handle10.1016/S1072-7515(98)00011-8 Occurrence Handle1:STN:280:DyaK1c7mvFSktQ%3D%3D Occurrence Handle9510258
DW Ollila AE Giuliano (1998) ArticleTitleIntraoperative lymphatic mapping and sentinel lymphadenectomy using isosulfan blue dye Breast Dis 8 297–300
D Krag D Weaver T Ashikaga (1998) ArticleTitleThe sentinel node in breast cancer: a multicenter validation study N Engl J Med 339 941–946 Occurrence Handle10.1056/NEJM199810013391401 Occurrence Handle1:STN:280:DyaK1cvhvVKntg%3D%3D Occurrence Handle9753708
R Offodile C Hoh SH Barsky (1998) ArticleTitleMinimally invasive breast carcinoma staging using lymphatic mapping with radiolabeled dextran Cancer 82 1704–1708
RM Roumen JG Valkenburg LM Geuskens (1997) ArticleTitleLymphoscintigraphy and feasibility of sentinel node biopsy in 83 patients with primary breast cancer Eur J Surg Oncol 23 495–502
PI Haigh NM Hansen K Qi (2000) ArticleTitleBiopsy method and excision volume do not affect success rate of subsequent sentinel lymph node dissection in breast cancer Ann Surg Oncol 7 21–27
TJ Miner CD Shriver DP Jacques (1999) ArticleTitleSentinel lymph node biopsy for breast cancer: the role of previous biopsy on patient eligibility Am Surg 65 493–499
SL Wong MJ Edwards C Chao (2002) ArticleTitleThe effect of prior biopsy method and concurrent definitive breast procedure on success and accuracy of sentinel lymph node biopsy Ann Surg Oncol 9 272–277
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Luini, A., Galimberti, V., Gatti, G. et al. The sentinel node biopsy after previous breast surgery: preliminary results on 543 patients treated at the European Institute of Oncology. Breast Cancer Res Treat 89, 159–163 (2005). https://doi.org/10.1007/s10549-004-1719-8
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10549-004-1719-8