Can you perform a Sentinel Lymph Node Mapping and Biospy (SLNM and SLNB) after Breast or Axillary Surgery?

• In 2014, The American Society of Clinical Oncology (ASCO) Guidelines were updated and published on the use of SLNB for early-stage breast cancer:
  • A strong recommendation was made for re-operative SLNM and SLNB in women who have undergone prior breast or axillary surgery.
• There are now multiple reports of successful second SLNM and SLNB in patients with a local breast cancer recurrence following a previous SLNB or even axillary lymph node dissection (ALND):
  • In a recent systematic review and meta-analysis of studies on repeat SLNB in locally recurrent breast cancer found that sentinel node identification was successful in 452 of the 692 patients (65.3%):
    • This percentage was significantly higher in patients who had undergone previous SLNB compared to previous ALND:
      • 81.0% vs 52.2%.
    • In most of these studies, a dual tracer technique, with use of blue dye and radiocolloid, was performed.
    • Aberrant drainage pathways were demonstrated in 43% of patients:
      • More frequently after previous ALND than after previous SLNB:
        • 69.2% vs 17.4%.
      • Lymphoscintigraphy, including examination of the contralateral axilla:
        • Should be performed if repeat SLNB is planned:
          • Given that these patients often have alternate drainage patterns.

REFERENCES

Rodrigo Arrangoiz MS, MD, FACS a surgical oncologist and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:

• He is an expert in the management of breast cancer.

  • If you have any questions about SLNM and SLNB is recurrent breast cancer please fill free to contact Dr. Arrangoiz.

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

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http://www.sociedadquirurigca.com