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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2019

01-08-2019 | Breast Oncology

Low Risk of Development of a Regional Recurrence After an Unsuccessful Repeat Sentinel Lymph Node Biopsy in Patients with Ipsilateral Breast Tumor Recurrence

Authors: Ingrid G. M. Poodt, MD, Coco J. E. F. Walstra, MD, Guusje Vugts, MD, PhD, Adriana J. G. Maaskant-Braat, MD, PhD, Adri C. Voogd, PhD, Robert-Jan Schipper, MD, PhD, Grard A. P. Nieuwenhuijzen, MD, PhD, the Sentinel Node And Recurrent Breast Cancer (SNARB) study group

Published in: Annals of Surgical Oncology | Issue 8/2019

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Abstract

Background

Unlike sentinel lymph node biopsy (SLNB) in the primary setting, the repeat SLNB (rSLNB) in patients with ipsilateral breast tumor recurrence (IBTR) is challenging, because it is difficult to visualize and/or harvest a sentinel lymph node in every patient. Regional treatments options and safety in terms of regional disease control after such an unsuccessful rSLNB remain unclear. This study assesses factors associated with the performance of axillary lymph node dissection (ALND) after unsuccessful rSLNB and evaluates the occurrence of regional recurrences.

Methods

Data were obtained from the Sentinel Node and Recurrent Breast Cancer (SNARB) study. In 239 patients, the rSLNB was unsuccessful, of whom 60 patients underwent ipsilateral ALND.

Results

A shorter time interval between primary treatment and IBTR, and a primary negative SLNB were significantly associated with a higher probability to be treated with ALND after unsuccessful rSLNB (P < 0.001). The 5-year regional-recurrence rate was 0.0% in the ALND group compared with 3.7% in the group treated without ALND (P = 0.113). Of the 179 patients treated without ALND, after a median follow-up of 5.1 years (range 0.3–13.2), 7 (3.9%) developed a regional recurrence as first event after unsuccessful rSLNB. None of the seven recurrences occurred in the ipsilateral axilla. Univariable analysis showed no factors associated with regional recurrence as first event after unsuccessful rSLNB (P > 0.05).

Conclusions

The present study demonstrates that the risk of regional recurrence in patients with an IBTR and an unsuccessful rSLNB is negligible, irrespective of the use of ALND. This suggests that there is no need for additional treatment of the axilla after an unsuccessful rSLNB.
Appendix
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Metadata
Title
Low Risk of Development of a Regional Recurrence After an Unsuccessful Repeat Sentinel Lymph Node Biopsy in Patients with Ipsilateral Breast Tumor Recurrence
Authors
Ingrid G. M. Poodt, MD
Coco J. E. F. Walstra, MD
Guusje Vugts, MD, PhD
Adriana J. G. Maaskant-Braat, MD, PhD
Adri C. Voogd, PhD
Robert-Jan Schipper, MD, PhD
Grard A. P. Nieuwenhuijzen, MD, PhD
the Sentinel Node And Recurrent Breast Cancer (SNARB) study group
Publication date
01-08-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07272-4

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