Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer
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Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer. / Uth, Charlotte Caspara; Christensen, Mette Haulund; Oldenbourg, Mette Holmqvist; Kjær, Christina; Garne, Jens Peter; Teilum, Dorthe; Kroman, Niels; Tvedskov, Tove Holst Filtenborg.
I: Annals of Surgical Oncology, Bind 22, Nr. 8, 08.2015, s. 2526-31.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer
AU - Uth, Charlotte Caspara
AU - Christensen, Mette Haulund
AU - Oldenbourg, Mette Holmqvist
AU - Kjær, Christina
AU - Garne, Jens Peter
AU - Teilum, Dorthe
AU - Kroman, Niels
AU - Tvedskov, Tove Holst Filtenborg
PY - 2015/8
Y1 - 2015/8
N2 - BACKGROUND: The aim of this study was to investigate the use of sentinel lymph node dissection (SLND) in the treatment of patients with locally recurrent breast cancer.METHODS: A total of 147 patients with locally recurrent breast cancer were included from five different breast surgery departments in Denmark. Data on previous breast and axillary surgery, adjuvant treatment, second operation in the breast and axilla, and lymphoscintigraphy were collected retrospectively from the original patient files.RESULTS: SLND after recurrence (SLNDAR) was successful in 72 of 144 patients (50 %). The detection rate was significantly higher after previous SLND (66 %) compared with previous ALND (34 %) [p = 0.0001]. Thirty-seven patients (51 %) who had previous SLND had a negative sentinel node. These patients could be spared an ALND. Six patients (8 %) who had a previous ALND had a metastatic sentinel node at recurrence; 17 % of patients had a sentinel node located outside the ipsilateral axilla; and eight patients with negative sentinel node at SLNDAR underwent completion ALND. None of these patients had metastases at completion ALND, corresponding to a false negative rate of 0 %.CONCLUSIONS: SLNDAR seems to be a feasible procedure in locally recurrent breast cancer and can spare a clinically significant number of patients an unnecessary ALND and the following risk of sequelae. In patients who had previous ALND, SLNDAR identified metastases that would have been overlooked following the current guidelines. A large proportion of patients had aberrant drainage, suggesting a need for lymphoscintigraphy.
AB - BACKGROUND: The aim of this study was to investigate the use of sentinel lymph node dissection (SLND) in the treatment of patients with locally recurrent breast cancer.METHODS: A total of 147 patients with locally recurrent breast cancer were included from five different breast surgery departments in Denmark. Data on previous breast and axillary surgery, adjuvant treatment, second operation in the breast and axilla, and lymphoscintigraphy were collected retrospectively from the original patient files.RESULTS: SLND after recurrence (SLNDAR) was successful in 72 of 144 patients (50 %). The detection rate was significantly higher after previous SLND (66 %) compared with previous ALND (34 %) [p = 0.0001]. Thirty-seven patients (51 %) who had previous SLND had a negative sentinel node. These patients could be spared an ALND. Six patients (8 %) who had a previous ALND had a metastatic sentinel node at recurrence; 17 % of patients had a sentinel node located outside the ipsilateral axilla; and eight patients with negative sentinel node at SLNDAR underwent completion ALND. None of these patients had metastases at completion ALND, corresponding to a false negative rate of 0 %.CONCLUSIONS: SLNDAR seems to be a feasible procedure in locally recurrent breast cancer and can spare a clinically significant number of patients an unnecessary ALND and the following risk of sequelae. In patients who had previous ALND, SLNDAR identified metastases that would have been overlooked following the current guidelines. A large proportion of patients had aberrant drainage, suggesting a need for lymphoscintigraphy.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Axilla
KW - Breast Neoplasms
KW - Dissection
KW - Female
KW - Humans
KW - Lymph Node Excision
KW - Lymph Nodes
KW - Lymphatic Metastasis
KW - Middle Aged
KW - Neoplasm Recurrence, Local
KW - Reoperation
KW - Retrospective Studies
KW - Sentinel Lymph Node Biopsy
U2 - 10.1245/s10434-014-4338-6
DO - 10.1245/s10434-014-4338-6
M3 - Journal article
C2 - 25564177
VL - 22
SP - 2526
EP - 2531
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 8
ER -
ID: 162113279