title: Sentinel lymph node biopsy and aberrant lymphatic drainage in recurrent breast cancer: Findings likely to change treatment decisions.
abstract: OBJECTIVE
  It is not clear whether sentinel lymph node biopsy (SLNB) can be applied to patients with a second breast cancer or recurrence occurring at previously treated breast. The purpose of this study was to assess the feasibility of SLNB procedure in patients with recurrent breast cancer.
  
  
  METHODS
  Patients with non-metastatic recurrent N0 breast cancer at ipsilateral breast were included. Patients were grouped according to their initial breast, axilla, and overall surgery. Presence of drainage and its pattern as well as SLNB success rate and overall axillary involvement rates were assessed. Findings were compared.
  
  
  RESULTS
  Out of 75 patients, mean age was 52.5 years and disease-free interval was 82 (9-312) months. Lymphatic drainage was successful in 42 (56%) patients. Drainage positivity was more frequent in patients who were previously treated with SLNB (82.6%) than in patients who underwent axillary lymph node dissection (ALND) (44.2%; P = 0,002). Aberrant lymphatic drainage was detected in 64.3% of drainage positive patients. Success rate of reoperative SLNB was 92.9%. Adjuvant treatment plan was altered in 12 (16%) patients. In 15 patients, negative SLNB prevented axillary dissection.
  
  
  CONCLUSIONS
  Reoperative SLNB seems to be technically feasible in N0 recurrent breast cancer patients. It may further avoid unnecessary ALND and lead changes in adjuvant treatment plans. J. Surg. Oncol. 2016;114:796-802. © 2016 2016 Wiley Periodicals, Inc.
authors: Surgical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey. hasankaranlik@yahoo.com.
authors: Hasan
authors: H
authors: Karanlik
authors: Department of General Surgery, Acibadem International Hospital, Istanbul, Turkey.
authors: Ilker
authors: I
authors: Ozgur
authors: Surgical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors: Berkay
authors: B
authors: Kilic
authors: Department of General Surgery, Albert Einstein Medical Center, Philadelphia, Pennsylvania.
authors: Alisan
authors: A
authors: Fathalizadeh
authors: Department of Nuclear Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors: Yasemin
authors: Y
authors: Sanli
authors: Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors: Semen
authors: S
authors: Onder
authors: Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors: Pinar
authors: P
authors: Saip
authors: Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors: Fatma
authors: F
authors: Sen
authors: Breast Surgery Unit, Department of General Surgery, Marmara University Hospital, Pendik, Istanbul, Turkey.
authors: Bahadir M
authors: BM
authors: Gulluoglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node / Q000473:pathology* / Q000503:physiopathology; D021701:Sentinel Lymph Node Biopsy
keywords: aberrant lymphatic drainage; breast cancer; recurrence; sentinel lymph node biopsy