Axillary Recurrence after Sentinel Lymph Node Biopsy for Breast Cancer

2010 ◽  
Vol 76 (10) ◽  
pp. 1127-1129 ◽  
Author(s):  
Christine Dauphine ◽  
Denis Nemtsev ◽  
David Rosing ◽  
Hernan I. Vargas
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Node Biopsy ◽  
Axillary Recurrence ◽  
Axillary Lymph ◽  
Node Biopsy

Sentinel lymph node biopsy (SLNB) is routinely performed as an axillary staging procedure for breast cancer. Although the reported false-negative rate approaches 10 per cent, this does not always lead to axillary recurrence. We previously reported an axillary recurrence rate of 1 per cent at a median follow-up of 2 years. Our objective is to determine the rate of axillary recurrence with longer follow-up. A retrospective review of patients with invasive breast cancer and a negative SLNB treated between 2001 and 2005 was performed. Cases where neoadjuvant therapy was used or where isolated tumor cells (ITCs) were found were included, whereas those with fewer than 18 months of follow-up were excluded. One (0.7%) out of 139 patients had an axillary recurrence after a median follow-up of 52 months. No patient who underwent neoadjuvant chemotherapy or with ITCs had axillary recurrence. Twelve (8.6%) patients have died, with death attributed to breast cancer in three. Our study demonstrates that axillary recurrence after SLNB remains a rare event after a median follow-up of 52 months, despite including potentially higher risk scenarios such as where neoadjuvant chemotherapy is used and ITCs are found. Therefore, axillary lymph node dissection can safely be avoided in patients where SLNB is negative.

SP8.1.7 Sentinel Lymph Node Biopsy or Neoadjuvant Chemotherapy- What comes first?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Smriti Karki ◽  
Yasmin Hassen ◽  
Arunmoy Chakravorty ◽  
Karolina Ajauskaite ◽  
Ekambaram Dinkara Babu
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Neoadjuvant Chemotherapy ◽  
Early Breast Cancer ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Nodal Disease ◽  
Node Biopsy

Abstract Aims NICE guidelines have not defined the timing of Sentinel Lymph Node Biopsy (SLNB) with respect to neoadjuvant chemotherapy (NACT). While there is an ongoing debate, the emerging consensus is in favour of SLNB following NACT in clinically node-negative (cN0) patients which confers the advantage of better prognostic outcomes as a negative SLNB negates further Axillary Lymph Node Dissection (ALND) and prevents patients having further unnecessary surgery. Thus, the aim of the study was to establish whether unnecessary ALND can be safely avoided by performing SLNB after NACT. Method Retrospective case records review of all patients treated with ALND at a single institution was undertaken from January 2018 to December 2019. Results 73 patients had ALND in this time frame. Patients received SLNB before NACT and ALND was performed if they were found node-positive on SLNB. Out of 73 patients, 24 patients had no further nodal disease, 26 had 1-2 macrometastasis and 23 had 3 or more macrometastasis on ALND. 57/73 patients had early breast cancer (T1/T2). 21/57 were cN0 but and 5/21 had NACT following SLNB and ALND after NACT. Of the 5 patients, 2 (40%) had no nodal disease on ALND. Conclusion 40% patients could have avoided ALND if SLNB was done after NACT. Also, 68% (50/73) patients who had ALND only had <2 lymph node macrometastasis. This data implies that patients with early breast cancer may be getting subjected to a second operation which not only is unnecessary but also may have debilitating complications.

scholarly journals Prevalence of Lymphedema in Women With Breast Cancer 5 Years After Sentinel Lymph Node Biopsy or Axillary Dissection: Objective Measurements

2008 ◽  
Vol 26 (32) ◽  
pp. 5213-5219 ◽  
Author(s):  
Sarah A. McLaughlin ◽  
Mary J. Wright ◽  
Katherine T. Morris ◽  
Gladys L. Giron ◽  
Michelle R. Sampson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Body Weight ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Biopsy

Purpose Sentinel lymph node biopsy was adopted for the staging of the axilla with the assumption that it would reduce the risk of lymphedema in women with breast cancer. The aim of this study was to determine the long-term prevalence of lymphedema after SLN biopsy (SLNB) alone and after SLNB followed by axillary lymph node dissection (SLNB/ALND). Patients and Methods At median follow-up of 5 years, lymphedema was assessed in 936 women with clinically node-negative breast cancer who underwent SLNB alone or SLNB/ALND. Standardized ipsilateral and contralateral measurements at baseline and follow-up were used to determine change in ipsilateral upper extremity circumference and to control for baseline asymmetry and weight change. Associations between lymphedema and potential risk factors were examined. Results Of the 936 women, 600 women (64%) underwent SLNB alone and 336 women (36%) underwent SLNB/ALND. Patients having SLNB alone were older than those having SLNB/ALND (56 v 52 years; P < .0001). Baseline body mass index (BMI) was similar in both groups. Arm circumference measurements documented lymphedema in 5% of SLNB alone patients, compared with 16% of SLNB/ALND patients (P < .0001). Risk factors associated with measured lymphedema were greater body weight (P < .0001), higher BMI (P < .0001), and infection (P < .0001) or injury (P = .02) in the ipsilateral arm since surgery. Conclusion When compared with SLNB/ALND, SLNB alone results in a significantly lower rate of lymphedema 5 years postoperatively. However, even after SLNB alone, there remains a clinically relevant risk of lymphedema. Higher body weight, infection, and injury are significant risk factors for developing lymphedema.

Patients with Breast Cancer and Negative Sentinel Lymph Node Biopsy without Additional Axillary Lymph Node Dissection: A Follow-Up Study of up to 5 Years

Oncology ◽  
2007 ◽  
Vol 72 (1-2) ◽  
pp. 27-32 ◽  
Author(s):  
Anna Domènech ◽  
Ana Benitez ◽  
María Teresa Bajén ◽  
María Jesús Pla ◽  
Miguel Gil ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Follow Up Study ◽  
Node Biopsy

scholarly journals Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy. It Is Worth To Decide!

2016 ◽  
Vol 26 (5) ◽  
pp. 84-87
Author(s):  
Agnė Čižauskaitė ◽  
Donatas Petrauskas ◽  
Dainius Šimčikas ◽  
Alvydas Česas
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Neoadjuvant Chemotherapy ◽  
Breast Surgery ◽  
Early Stage ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Biopsy

Objective. To evaluate the predictable percentage of patients that could be eligible for sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in Klaipeda University Hospital Breast Surgery Department. Background. Although SLNB is a standard staging method for axillar node status assessment for early- stage clinically lymph node (LN) negative breast cancer patients, SLNB after NAC is still controversial. Axillary lymph node dissection (ALND) still remains standard accepted surgical approach for patients following NAC regardless of primary LN status. ALND is associated with significant morbidity and complications. NAC is now used with increasing frequency not only for locally advanced but also for early-stage breast cancer and optimal indications for SLNB after NAC are required. Methods. 163 cases with breast cancer treated by NAC were enrolled in this study. After NAC all patients at the time of definitive breast surgery, underwent ALND. Results. Before NAC, clinical LN status was negative in 21 cases (13%) and positive in 141 (87%). When evaluated postoperatively, pN0 in clinically LN negative group was detected in 21 patients (100%). Meanwhile in clinically LN positive group, pN0 was 63 (44.7%) and pN+ 78 (55.3%) of cases. Conclusions. SLNB should always be performed before or after NAC in clinically LN negative patients. Optimal technique should be chosen in node- positive patients to assure the success of the procedure.

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