title: Evaluation of sentinel lymph node biopsy after previous breast surgery for breast cancer: GATA study.
abstract: OBJECTIVE
  Sentinel lymph node (SLN) biopsy was recently recommended after prior breast tumour surgery and lymphadenectomy is not the gold standard anymore for nodal staging after a lesion's removal. The purpose of our study was to evaluate the good practices of use of SLN biopsy in this context.
  
  
  METHODS
  From 2006 to 2012, 138 patients having undergone a surgical biopsy without prior diagnosis of an invasive carcinoma with a definitive histological analysis in favour of this diagnosis were included in a prospective observational multicentric study. Each patient had a nodal staging following SLN biopsy with subsequent systematic lymphadenectomy.
  
  
  RESULTS
  The detection rate of SLN was 85.5%. The average number of SLNs found was 1.9. The relative detection failure risk rate was multiplied by 4 in the event of an interval of less than 36 days between the SLN biopsy and the previous breast surgery, and by 9 in the event of using a single-tracer detection method. The false negative rate was 6.25%. The prevalence of metastatic axillary node involvement was 11.6%. In 69% of cases only the SLN was metastatic. The post-operative seroma rate was 19.5%.
  
  
  CONCLUSIONS
  Previous conservative breast tumour surgery does not affect the accuracy of the SLN biopsy. A sufficient interval of greater than 36 days between the two operations could allow to improve the SLN detection rate, although further studies are needed to validate this statement.
  
  
  BACKGROUND
  NCT00293865.
authors.affiliation: Department of Oncologic Surgery, René-Gauducheau Center - ICO, boulevard Jean-Monod, 44805 Nantes-Saint-Herblain, France.
authors.forename: C
authors.initials: C
authors.lastname: Renaudeau
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital - Angers, 4 rue Larrey, 49933 Angers Cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Lefebvre-Lacoeuille
authors.affiliation: Department of Oncologic Surgery, René-Gauducheau Center - ICO, boulevard Jean-Monod, 44805 Nantes-Saint-Herblain, France.
authors.forename: L
authors.initials: L
authors.lastname: Campion
authors.affiliation: Department of Oncologic Surgery, René-Gauducheau Center - ICO, boulevard Jean-Monod, 44805 Nantes-Saint-Herblain, France.
authors.forename: F
authors.initials: F
authors.lastname: Dravet
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital - Angers, 4 rue Larrey, 49933 Angers Cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Descamps
authors.affiliation: Department of Oncologic Surgery, Claudius-Regaud Institute - IUCT, 1 Av. Irène Joliot-Curie, 31100 Toulouse, France.
authors.forename: G
authors.initials: G
authors.lastname: Ferron
authors.affiliation: Department of Oncologic Surgery, Paoli-Calmette Institute, 232 boulevard Ste Marguerite, 13009 Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Houvenaeghel
authors.affiliation: Department of Oncologic Surgery, Oscar-Lambret Center, 3 rue Frédéric Combemale, 59020 Lille Cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Giard
authors.affiliation: Department of Oncologic Surgery, Bergonié Institute, 229 cours Argonne, 33000 Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Tunon de Lara
authors.affiliation: Department of Gynecological and Mammary Oncologic Surgery, University Hospital - Augustin-Morvan, 2 avenue Foch, 29200 Brest, France.
authors.forename: P F
authors.initials: PF
authors.lastname: Dupré
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital - La-Milétrie, 2 rue de la Milétrie, 86021 Poitiers Cedex, France.
authors.forename: X
authors.initials: X
authors.lastname: Fritel
authors.affiliation: Department of Gynecologic and Breast Surgery, Georges Pompidou European Hospital, APHP Paris and Paris Descartes University, School of Medicine, 20 rue Leblanc, 75015 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Ngô
authors.affiliation: Department of Oncologic Surgery, Alexis-Vautrin Center, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Verhaeghe
authors.affiliation: Department of Oncologic Surgery, Léon-Bérard Center, 28 rue Laennec, 69008 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Faure
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital - Angers, 4 rue Larrey, 49933 Angers Cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Mezzadri
authors.affiliation: Department of Obstetrics and Gynecology, Departmental Hospital - Vendée, Les Oudairies, 85929 La Roche-sur-Yon Cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Damey
authors.affiliation: Department of Oncologic Surgery, René-Gauducheau Center - ICO, boulevard Jean-Monod, 44805 Nantes-Saint-Herblain, France. Electronic address: jean-marc.classe@ico.unicancer.fr.
authors.forename: J M
authors.initials: JM
authors.lastname: Classe
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000556:secondary* / Q000601:surgery*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects; D049291:Seroma / Q000209:etiology
keywords: Invasive breast carcinoma; Previous breast surgery; Sentinel lymph node biopsy; Surgical biopsy