The Role of redo-Sentinel Lymph Node Biopsy in Patients With Prior Ipsilateral Breast Cancer Surgery

Margo-Rose F Macnab; Gabrielle Slater; Mairi Fuller; Beatrix Elsberger; Lesley Lovell; Roger T Staff; Yazan A Masannat

doi:10.1016/j.clbc.2022.01.012

The Role of redo-Sentinel Lymph Node Biopsy in Patients With Prior Ipsilateral Breast Cancer Surgery

Clin Breast Cancer. 2022 Jul;22(5):e674-e679. doi: 10.1016/j.clbc.2022.01.012. Epub 2022 Feb 3.

Authors

Margo-Rose F Macnab¹, Gabrielle Slater², Mairi Fuller³, Beatrix Elsberger³, Lesley Lovell¹, Roger T Staff¹, Yazan A Masannat⁴

Affiliations

¹ Nuclear Medicine Department, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
² The School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, UK.
³ The School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, UK; The Breast Unit, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
⁴ The School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, UK; The Breast Unit, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK. Electronic address: yazanmas@hotmail.com.

PMID: 35279407
DOI: 10.1016/j.clbc.2022.01.012

Abstract

Background: Sentinel Lymph Node Biopsy (SLNB) is used to stage the axilla, but there is limited data in patients with prior ipsilateral breast cancer. This study compares redo-SLNB (reSLNB) and Axillary node sample (ANS) in this sub-cohort of patients.

Materials and methods: This is a retrospective study looking at patients with a new ipsilateral primary or recurrence with history of breast-conserving surgery. Planned and performed surgery, patient demographics and previous treatments were recorded. Node positivity and success rate of reSLNB was analyzed.

Results: A total of 86 patients were identified that had mastectomy for ipsilateral recurrent disease with radiologically negative axilla. Out of the 48 that had reSLNB, 35(72.9%) were successful. Nineteen percent of the reSLNB had positive axillae and 20% of the ANS patients. reSLNB success rate was significantly lower amongst patients with previous axillary surgery (P = .014) and previous positive nodes(P = .001).

Conclusion: reSLNB should be considered to restage the axilla in patients with previous history of ipsilateral cancer especially that there is growing evidence showing good identification rate.

Keywords: Axillary Surgery; Axillary node sample; Breast cancer recurrence; Breast surgery; Sentinel node biopsy.

MeSH terms

Axilla / pathology
Axilla / surgery
Breast Neoplasms* / pathology
Breast Neoplasms* / surgery
Female
Humans
Lymph Nodes / pathology
Mastectomy
Neoplasm Recurrence, Local / surgery
Retrospective Studies
Sentinel Lymph Node Biopsy*