Technical feasibility of sentinel lymph node biopsy in patients with ipsilateral breast tumor recurrence and previous axillary surgery.
BACKGROUND
The role of sentinel lymph node biopsy (SLNB) in patients with ipsilateral breast tumor recurrence (IBTR) remains to be elucidated. The aim of this study was to evaluate feasibility and validity of SLNB in patients with IBTR.


METHODS
A prospective database of 1172 patients with clinically node-negative breast cancer who underwent SLNB from January 2005 to December 2013 at Keio University Hospital was analyzed and 35 patients with IBTR underwent SLNB. Sentinel lymph nodes (SLNs) were detected using a combined method of blue dye and radioisotope or indocyanine green fluorescence in cases with failure of identification by blue dye and radioisotope.


RESULTS
Twenty-two patients had previous SLNB, eight had previous axillary lymph node dissection (ALND), and five had no previous axillary surgery. Overall, SLNs were successfully identified in 28 (80.0%) of 35 patients. The identification rate in patients with previous SLNB, ALND and no axillary surgery was 81.8% (18/22), 75% (6/8) and 80% (4/5), respectively (P = 0.52). Aberrant drainage outside the ipsilateral axilla was found more frequently in patients with previous ALND compared with SLNB and no axillary treatment (37.5% vs. 4.5% vs. 0%, P = 0.048). No axillary recurrence was observed after median follow-up of 40.3 months from the second surgery for IBTR.


CONCLUSIONS
SLNB is a technically feasible and valid procedure for staging and treatment of regional lymph nodes in patients with IBTR.
Department of Surgery, Inagi Municipal Hospital, 1171 Ohmaru, Inagi, Tokyo, 206-0801, Japan.
Akiko
A
Matsumoto
Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan. Electronic address: jinnoh@dd.iij4u.or.jp.
Hiromitsu
H
Jinno
Department of Surgery, Inagi Municipal Hospital, 1171 Ohmaru, Inagi, Tokyo, 206-0801, Japan.
Tetsuya
T
Nakamura
Department of Surgery, Inagi Municipal Hospital, 1171 Ohmaru, Inagi, Tokyo, 206-0801, Japan.
Junichi
J
Saito
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
Maiko
M
Takahashi
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
Tetsu
T
Hayashida
Division of Pathological Diagnosis, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
Kaori
K
Kameyama
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
Yuko
Y
Kitagawa
D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy
Axillary lymph node dissection; Breast cancer; Ipsilateral breast tumor recurrence; Lymphatic mapping; Sentinel lymph node biopsy