title: Influence of previous breast surgery in sentinel lymph node biopsy in patients with breast cancer.
abstract: OBJECTIVE
  The aim of this study was to review the feasibility of selective sentinel lymph node biopsy in patients with previous surgery for breast cancer, as well as to examine the factors that may interfere with sentinel node detection.
  
  
  METHODS
  A retrospective review was performed on 91 patients with breast cancer and previous breast surgery, and who underwent sentinel lymph node biopsy. Patients were divided into two groups according to their previous treatment: aesthetic breast surgery in 30 patients (group I) and breast-conserving surgery in 61 (group II). Lymphoscintigraphy was performed after an intra-tumour injection in 21 cases and a peri-areolar injection in 70 cases. An analysis was made of lymphatic drainage patterns and overall sentinel node detection according to clinical, pathological and surgical variables.
  
  
  RESULTS
  The overall detection of the sentinel lymph node in the lymphoscintigraphy was 92.3%, with 7.7% of extra-axillary drainages. The identification rate was similar after aesthetic breast surgery (93.3%) and breast-conserving surgery (91.8%). Sentinel lymph nodes were found in the contralateral axilla in two patients (2.2%), and they were included in the histopathology study. The non-identification rate in the lymphoscintigraphy was 7.7%. There was a significantly higher non-detection rate in the highest histological grade tumours (28.6% grade III, 4.5% grade I and 3.6% grade II).
  
  
  CONCLUSIONS
  Sentinel lymph node biopsy in patients with previous breast surgery is feasible and deserves further studies to assess the influence of different aspects in sentinel node detection in this clinical scenario. A high histological grade was significantly associated with a lower detection.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valencia, Valencia, España. Electronic address: loprive@hotmail.com.
authors.forename: V
authors.initials: V
authors.lastname: López-Prior
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: R
authors.initials: R
authors.lastname: Díaz-Expósito
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: I
authors.initials: I
authors.lastname: Casáns Tormo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001365:Axilla; D018427:Breast Implants; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D061305:Lymphoscintigraphy; D016462:Mammaplasty; D015412:Mastectomy, Segmental; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy
keywords: Breast cancer; Cirugía previa; Cáncer de mama; Ganglio centinela; Linfogammagrafía; Lymphoscintigraphy; Previous surgery; Sentinel lymph node