- Although there are no randomized data:
- Multiple retrospective and observational studies:
- Have evaluated SLNB in patients who have had previous breast or axillary operations
- Multiple retrospective and observational studies:
- Previous breast conservation or excisional biopsy:
- Does not appear to affect the accuracy of the SLN biopsy
- Completion ALND:
- Has been routinely recommended for all patients:
- With local recurrence:
- However, 60% to 90% of such patients:
- Are node negative
- However, 60% to 90% of such patients:
- With local recurrence:
- Reoperative SLNB:
- Has been shown to be accurate after local recurrence:
- And spares some patients from an unnecessary ALND
- Has been shown to be accurate after local recurrence:
- Has been routinely recommended for all patients:
- Successful identification of a sentinel node:
- However, is inversely related to the number of nodes removed during the initial operation:
- One study evaluating SLNB after previous axillary operations:
- Reported successful sentinel lymph node identification in:
- 68% of patients with less than nine nodes removed previously:
- But only 38% in patients with nine or more nodes previously excised
- 68% of patients with less than nine nodes removed previously:
- Reported successful sentinel lymph node identification in:
- One study evaluating SLNB after previous axillary operations:
- Rates of extra-axillary sentinel node localization:
- Range from 8% to 63% in patients:
- With previous axillary operations
- Patients who had a previous ALND:
- Have the highest rates of extra-axillary localization:
- Preoperative lymphoscintigraphy:
- In addition to blue dye is recommended for SLNB after previous axillary operation to aid in localization and identification of extra-axillary drainage
- Preoperative lymphoscintigraphy:
- Have the highest rates of extra-axillary localization:
- Range from 8% to 63% in patients:
- However, is inversely related to the number of nodes removed during the initial operation:
#Arrangoiz #BreastSurgeon #BreastExpert #BreastCancer #CancerSurgeon #SurgicalOncologist #MountSinaiMedicalCenter #MSMC #Miami #Mexico #SLNM #SLNB #SentinelLymphNodeBiospy
Rodrigo Arrangoiz MS, MD, FACS, FSSO 