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Contralateral Axillary Lymph Node Metastases Detected by Repeat Sentinel Lymph Node Biopsy in a Patient with
1Department of Breast and Endocrine Surgery, Matsue City Hospital, Matsue, Shimane, Japan.
Introduction:
There is no consensus on the significance of repeat sentinel lymph node (SLN) biopsy in a patient with ipsilateral breast tumor recurrence (IBTR).
Case Presentation:
A 49-year-old premenopausal woman developed an ipsilateral breast cancer (BC) lesion after previously undergoing lumpectomy, SLN biopsy, and adjuvant radiation therapy for left-sided lobular carcinoma in situ at the age of 35. Because of the contralateral SLNs identified on radioisotope lymphoscintigraphy, we decided to perform a left mastectomy with contralateral axillary lymph node dissection. Intraoperative SLN mapping using indigo carmine was negative. A total of 3 contralateral axillary lymph node metastases, all sentinel nodes, were identified among 18 resected nodes. Because this patient's second BC was an invasive ductal carcinoma, a different histology from her first tumor, we diagnosed a new primary BC along with contralateral axillary lymph node metastases and planned adjuvant therapy accordingly.
Conclusions:
Repeat SLN biopsy for IBTR plays a key role in determining accurate SLN status and in optimizing adjuvant therapy.
