Use of reoperative sentinel lymph node biopsy in breast cancer patients.
BACKGROUND
Ipsilateral breast recurrence or second primary breast cancer can develop in patients who have undergone breast conservation and sentinel lymph node biopsy (SLNB). This brings into question the necessity of complete axillary lymph node dissection (CALND) versus a second SLNB (remapping). Our objective is to determine the feasibility of a reoperative SLNB.


METHODS
A review of patients receiving a reoperative SLNB between April 1994 and December 2006 was conducted with IRB approval. Fifty-six patients underwent a second SLNB on the ipsilateral side an average of 42.5 months after their first SLNB.


RESULTS
Sentinel lymph nodes were successfully remapped in 45 of 56 (80.4%) patients. Of 45 patients successfully remapped, 36 (80%) were node negative and were spared CALND. There was only 1 patient (2.2%) in whom a sentinel lymph node was identified outside of the ipsilateral axilla. At 26 months mean followup for the second SLNB, there have been no axillary recurrences and 1 death.


CONCLUSIONS
Our findings demonstrate that remapping sentinel nodes in patients with ipsilateral recurrence or new primary breast cancer after SLNB achieved success in 80.4% of patients. Overall, 80.0% (36 of 45) of the successfully remapped patients were spared a CALND.
Cox
Charles E
CE
Department of Surgery, H Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL 33612, USA. charles.cox@moffitt.org
Furman
Ben T
BT
Kiluk
John V
JV
Jara
Julia
J
Koeppel
William
W
Meade
Tammi
T
White
Laura
L
Dupont
Elisabeth
E
Allred
Nathon
N
Meyers
Michael
M
D001943:Breast Neoplasms / Q000473:pathology*; D005240:Feasibility Studies; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D012086:Reoperation; D021701:Sentinel Lymph Node Biopsy; D013997:Time Factors