Can Sentinel Lymph Node Biopsy (SLNB) be Performed in a Patient that has had Breast Conservation with SLNB?

• In 2014, updated The American Society of Clinical Oncology (ASCO) Guidelines were published on the use of SLNB for early-stage breast cancer:
  • • A strong recommendation was made for reoperative SLNB:
      • In women who have undergone prior breast or axillary surgery.
    • There are now multiple reports of successful second SLNB in patients with a local breast cancer recurrence following a previous SLNB or even axillary lymph node dissection (ALND):
      • 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
  • Lyman GH, Temin S, Edge SB, et al. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology Clinical Practice Guideline update. J Clin Oncol. 2014; 32:1365-1383.
  • Maaskant-Braat AJ, Voogd AC, Roumen RM, et al. Repeat sentinel node biopsy in patients with locally recurrent breast cancer: a systematic review and meta-analysis of the literature. Breast Cancer Res Treat. 2013;138:13-20.

👉Rodrigo Arrangoiz MS, MD, FACScirujano oncology y miembro de Sociedad Quirúrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

• Es experto en el manejo del patología de mama:

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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