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Evaluating the feasibility of repeat sentinel lymph node biopsy in ipsilateral breast tumor recurrence: Technical considerations and oncologic outcomes

  • 0Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology +

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September 6, 2024

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September 6, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Repeat sentinel lymph node biopsy (rSLNB) is feasible for ipsilateral breast tumor recurrence (IBTR), especially for tumors outside the upper-outer quadrant. Careful surveillance is crucial for aggressive subtypes like triple-negative IBTR.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background

  • Ipsilateral breast tumor recurrence (IBTR) is a clinical concern following initial breast cancer treatment.
  • Less invasive surgical approaches are increasingly favored due to advances in early detection.
  • The efficacy of repeat sentinel lymph node biopsy (rSLNB) for IBTR requires further investigation despite NCCN guideline considerations.

Purpose Of The Study

  • To assess lymphatic drainage patterns in patients with IBTR.
  • To evaluate the technical feasibility and oncologic outcomes of rSLNB in IBTR.
  • To identify factors influencing lymphatic mapping success and recurrence risk.

Main Methods

  • Retrospective analysis of 78 patients with IBTR who previously underwent breast-conserving surgery (BCS) and sentinel lymph node biopsy (SLNB).
  • Data collected included patient demographics, tumor characteristics, lymphatic mapping techniques (e.g., blue dye, lymphoscintigraphy), and oncologic outcomes.
  • Statistical analysis was performed to identify correlations between tumor location, patient factors, and rSLNB outcomes.

Main Results

  • Successful rSLNB was achieved in 82.1% of patients, with lymphatic drainage primarily to the ipsilateral axilla (80.8%).
  • Initial tumor location significantly impacted lymphatic mapping success (p=0.019).
  • A third cancer event occurred in 28.8% of invasive IBTR cases, associated with postmenopausal status, higher T stages, and HR(-)/HER2(-) subtype (p<0.001). The risk of a third event increased significantly within 2 years post-IBTR.

Conclusions

  • rSLNB is technically feasible for IBTR, particularly for tumors located outside the upper-outer quadrant.
  • Combining blue dye with lymphoscintigraphy may improve rSLNB success rates.
  • Active surveillance is recommended for aggressive IBTR subtypes, such as triple-negative breast cancer, due to their rapid progression potential.

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