title: The sentinel node biopsy after previous breast surgery: preliminary results on 543 patients treated at the European Institute of Oncology.
abstract: BACKGROUND
  Sentinel lymph node biopsy (SLNB) is an accurate alternative to complete axillary lymph node dissection (ALND) in clinically node-negative breast cancer patients. A previous breast biopsy has been considered a relative contraindication to SLNB. We examined the accuracy of SLNB by following the axillary relapses after the procedure in patients who had undergone a breast biopsy before SLNB.
  
  
  METHODS
  Up to December 2003, 4351 patients with the diagnosis of invasive breast cancer underwent SLNB at the European Institute of Oncology. Already, 543 of these patients had undergone a breast biopsy; from June 1997 to January 2004, these patients received SLNB by lymphoscintigraphy performed on the biopsy area. We followed these patients with a clinical assessment every 6 months and instrumental examinations every year, particularly focusing on the research of axillary relapse of disease.
  
  
  RESULTS
  In 70.4% of cases, the sentinel node was negative, and only three cases underwent further axillary dissection. The sentinel node was identified in 99% of cases and this was the only positive node in 61.5% of cases with positive axillary nodes. The median follow-up was 2 years; 4 nodal recurrences were observed: 3 axillary lymph node relapses and 1 loco-regional.
  
  
  CONCLUSIONS
  SLNB accuracy after a previous breast biopsy is comparable with the results obtained in validation studies. SLNB after a previous breast biopsy can be considered a standard procedure. Lymphoscintigraphy identifies the sentinel node in 99% of patients.
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, via Ripamonti 435, 20141 Milan, Italy. alberto.luini@ieo.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.forename: Viviana
authors.initials: V
authors.lastname: Galimberti
authors.forename: Giovanna
authors.initials: G
authors.lastname: Gatti
authors.forename: Paolo
authors.initials: P
authors.lastname: Arnone
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Vento
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trifirò
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.forename: Julia Rodriguez
authors.initials: JR
authors.lastname: Fernandez
authors.forename: Daniela
authors.initials: D
authors.lastname: Gilardi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paganelli
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D000075202:Contraindications; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000592:standards*