title: Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer.
abstract: BACKGROUND
  The aim of this study was to investigate the use of sentinel lymph node dissection (SLND) in the treatment of patients with locally recurrent breast cancer.
  
  
  METHODS
  A total of 147 patients with locally recurrent breast cancer were included from five different breast surgery departments in Denmark. Data on previous breast and axillary surgery, adjuvant treatment, second operation in the breast and axilla, and lymphoscintigraphy were collected retrospectively from the original patient files.
  
  
  RESULTS
  SLND after recurrence (SLNDAR) was successful in 72 of 144 patients (50 %). The detection rate was significantly higher after previous SLND (66 %) compared with previous ALND (34 %) [p = 0.0001]. Thirty-seven patients (51 %) who had previous SLND had a negative sentinel node. These patients could be spared an ALND. Six patients (8 %) who had a previous ALND had a metastatic sentinel node at recurrence; 17 % of patients had a sentinel node located outside the ipsilateral axilla; and eight patients with negative sentinel node at SLNDAR underwent completion ALND. None of these patients had metastases at completion ALND, corresponding to a false negative rate of 0 %.
  
  
  CONCLUSIONS
  SLNDAR seems to be a feasible procedure in locally recurrent breast cancer and can spare a clinically significant number of patients an unnecessary ALND and the following risk of sequelae. In patients who had previous ALND, SLNDAR identified metastases that would have been overlooked following the current guidelines. A large proportion of patients had aberrant drainage, suggesting a need for lymphoscintigraphy.
authors.affiliation: Brystkirurgisk klinik, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Charlotte Caspara
authors.initials: CC
authors.lastname: Uth
authors.forename: Mette Haulund
authors.initials: MH
authors.lastname: Christensen
authors.forename: Mette Holmqvist
authors.initials: MH
authors.lastname: Oldenbourg
authors.forename: Christina
authors.initials: C
authors.lastname: Kjær
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Garne
authors.forename: Dorthe
authors.initials: D
authors.lastname: Teilum
authors.forename: Niels
authors.initials: N
authors.lastname: Kroman
authors.forename: Tove Filtenborg
authors.initials: TF
authors.lastname: Tvedskov
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D004210:Dissection; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery*; D011877:Radionuclide Imaging; D012086:Reoperation; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy