Sentinel lymph node biopsy and aberrant lymphatic drainage in recurrent breast cancer: Findings likely to change treatment decisions

• Published in: Journal of surgical oncology 2016-12, Vol.114 (7), p.796-802
• Main Authors: Karanlik, Hasan, Ozgur, Ilker, Kilic, Berkay, Fathalizadeh, Alisan, Sanli, Yasemin, Onder, Semen, Saip, Pinar, Sen, Fatma, Gulluoglu, Bahadir M.
• Format: Article
• Language: English
• Subjects: aberrant lymphatic drainage; Adult; Aged; Aged, 80 and over; Axilla; breast cancer; Breast Neoplasms - pathology; Breast Neoplasms - physiopathology; Breast Neoplasms - therapy; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - physiopathology; Carcinoma, Ductal, Breast - therapy; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Intraductal, Noninfiltrating - physiopathology; Carcinoma, Intraductal, Noninfiltrating - therapy; Feasibility Studies; Female; Follow-Up Studies; Humans; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - physiopathology; Neoplasm Recurrence, Local - therapy; recurrence; Retrospective Studies; Sentinel Lymph Node - pathology; Sentinel Lymph Node - physiopathology; Sentinel Lymph Node Biopsy
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.24423

Background and Objectives 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.