Selective sentinel lymph node biopsy in breast cancer local recurrence

Area of Science:

• Oncology
• Surgical Oncology
• Nuclear Medicine

Background:

• Local breast tumor recurrence affects 5-10% of patients.
• Inadequate axillary re-staging increases risks of further recurrence and mortality.
• Sentinel lymph node biopsy in recurrences (rSLNB) is a potential tool for axillary evaluation.

Purpose of the Study:

• To assess the success rate of rSLNB in patients with ipsilateral breast tumor recurrence.
• To evaluate the impact of prior treatments (axillary surgery, breast surgery, adjuvant therapies) on rSLNB outcomes.
• To determine overall and aberrant drainage rates and metastasis detection in rSLNB.

Main Methods:

• Retrospective analysis of 52 patients with ipsilateral breast tumor recurrence who underwent rSLNB.
• Data collected included demographics, tumor characteristics, previous treatments, and drainage patterns.
• Statistical analysis was performed using R software.

Main Results:

• The overall drainage rate for rSLNB was 83%, with 91% of these undergoing excision.
• Previous sentinel lymph node biopsy (SLNB) significantly increased the overall migration rate (92% vs 60%).
• Previous axillary lymphadenectomy (ALND) significantly increased aberrant drainage rates (53% vs 24%). Metastases were found in 13% of cases, with 20% in aberrant drainage sites.

Conclusions:

• rSLNB is a feasible technique for evaluating axillary status in ipsilateral breast tumor recurrence.
• The procedure identifies metastases in aberrant drainage territories, crucial for accurate locoregional management.
• rSLNB is essential for comprehensive axillary staging in recurrent breast cancer.