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Published in:

01-08-2006

Sentinel Lymph Node Biopsy for Local Recurrence of Breast Cancer After Breast-Conserving Therapy

Authors: Bret Taback, MD, Phong Nguyen, MD, Nora Hansen, MD, G. Keith Edwards, MD, Kim Conway, BS, Armando E. Giuliano, MD

Published in: Annals of Surgical Oncology | Issue 8/2006

Abstract

Background

Lymphatic mapping (LM) with sentinel lymph node (SLN) biopsy has revolutionized the surgical staging of primary breast cancer, but its utility and feasibility have not been established in patients with ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) and radiation.

Methods

We reviewed our breast cancer database to identify all patients who underwent preoperative lymphoscintigraphy for IBTR and whose primary tumor had been managed by BCS, SLN biopsy and/or axillary node dissection, and adjuvant breast irradiation.

Results

Preoperative lymphoscintigraphy identified migration to the regional nodal drainage basins in 11 (73%) of 15 patients, as follows: 5 ipsilateral axillary, 1 supraclavicular, 2 internal mammary, 2 interpectoral, and 3 contralateral axillary. Two patients demonstrated drainage to two nodal basins. In four patients, no drainage was observed. Intraoperative LM with radioisotope plus blue dye identified at least 1 SLN in 11 of 14 patients, and histopathologic evaluation revealed metastasis in 3 patients (2 contralateral axillary and 1 ipsilateral axillary). During preoperative lymphoscintigraphy, the radiocolloid migration time tended to be longer and the drainage pathways more variable than those associated with primary tumors.

Conclusions

LM/SLN biopsy can be successfully performed in patients with IBTR after prior BCS, axillary surgical staging, and adjuvant radiation. This approach illustrates variations in the lymphatic drainage of recurrent breast tumors and may permit the identification of regional metastasis not noted with conventional imaging techniques.

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Title: Sentinel Lymph Node Biopsy for Local Recurrence of Breast Cancer After Breast-Conserving Therapy
Authors: Bret Taback, MD
Phong Nguyen, MD
Nora Hansen, MD
G. Keith Edwards, MD
Kim Conway, BS
Armando E. Giuliano, MD
Publication date: 01-08-2006
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 8/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/ASO.2006.08.026

At a glance: The STEP trials

Springer Medicine

Sentinel Lymph Node Biopsy for Local Recurrence of Breast Cancer After Breast-Conserving Therapy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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