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Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer
Charlotte Caspara Uth1, Mette Haulund Christensen, Mette Holmqvist Oldenbourg
1Brystkirurgisk klinik, Rigshospitalet, Copenhagen, Denmark.
Annals of Surgical Oncology
|January 8, 2015
Summary
Sentinel lymph node dissection after recurrence (SLNDAR) is feasible for locally recurrent breast cancer. This procedure can help avoid unnecessary axillary lymph node dissection (ALND) and identify overlooked metastases.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Locally recurrent breast cancer presents unique treatment challenges.
- Sentinel lymph node dissection (SLND) is a standard procedure for initial breast cancer staging.
- The role of SLND in recurrent disease requires further investigation.
Purpose of the Study:
- To evaluate the efficacy and feasibility of sentinel lymph node dissection after recurrence (SLNDAR) in patients with locally recurrent breast cancer.
- To determine if SLNDAR can spare patients from completion axillary lymph node dissection (ALND).
- To assess the detection rate of metastases in recurrent breast cancer using SLNDAR.
Main Methods:
- Retrospective analysis of 147 patients with locally recurrent breast cancer from five Danish breast surgery departments.
- Data collection included previous breast and axillary surgery, adjuvant treatment, and lymphoscintigraphy.
- SLNDAR was performed as a second procedure in the breast and axilla.
Main Results:
- SLNDAR was successful in 50% of patients (72/144).
- The detection rate was significantly higher after prior SLND (66%) compared to prior axillary lymph node dissection (ALND) (34%).
- SLNDAR identified metastases in 8% of patients with prior ALND, which might have been missed by current guidelines. Aberrant lymphatic drainage was observed in a significant proportion of patients.
Conclusions:
- SLNDAR is a feasible procedure for locally recurrent breast cancer.
- SLNDAR can spare a significant number of patients from unnecessary ALND and its associated risks.
- SLNDAR is valuable for identifying metastases in patients with prior ALND and highlights the importance of lymphoscintigraphy due to aberrant drainage.
