e21056 Background: In the field of sentinel lymph node (SLN) for patients with previously breast surgery, opinions are not definitive. On the first hand, the ASCO in 2005 recommended that SLN biopsy should not be performed in patients with previous mammaplasty or axillary surgery, but, on the other hand, the same panelists of the ASCO guideline suggested that a preliminary lymphoscintigraphy (LSG) could be done when considering a SLN biopsy in patients with previous mammaplasty, with the objective of verifying the integrity of axillary nodes. We started a prospective study in January 2009, to evaluate the location of sentinel lymph node (SLN) before and after mammaplasty. The preliminary results of the first 20 patients were presented in June 2010 (Chicago, ASCO), however it was to be necessary to have more patients to validate these encouraging results. The results of additional study is presented here. Methods: 40 patients who underwent mammaplasty were evaluated by LSG acquired with a SPECT-CT immediately after intradermal periareolar injections of 99mTc -labelled sulphur colloid at two time points: before mammaplasty (Pre-LSG) and between 40 to 60 days after mammaplasty (Post- LSG). Results: The localisation of hot SN was evaluated as in the first study, using the SPECT-CT images : - antero-posterior distance was estimated in centimeter from SLN region to dorsal vertebrae spine center. - SLN’s coronal position was compared to rib cage. The average value of 40 antero-posterior distance before and after surgery was 14.2 vs 14.4 centimeters, in the preliminary study it was 13.6 vs 13.8 centimeters, the difference keeps the same between 2 studies (2 millimeters). As in the first study, SN was in the same position in relation to grill rib. The binomial test did not show statistical difference in lymphatic drainage patterns between Pre-LSG and Post-LSG. Conclusions: after evaluating the impact of the previous mammaplasty surgery on the SLN position, we observed that surgery did not modify lymphatic mapping and thus that it may be possible to propose SLN biopsy even after mammaplasty. This study confirms the results of our preliminary study.