Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer

Abstract

SLNDAR seems to be a feasible procedure in locally recurrent breast cancer and can spare a clinically significant number of patients an unnecessary ALND and the following risk of sequelae. In patients who had previous ALND, SLNDAR identified metastases that would have been overlooked following the current guidelines. A large proportion of patients had aberrant drainage, suggesting a need for lymphoscintigraphy.

Meta-analysis of aberrant lymphatic drainage in recurrent breast cancer

“…The detailed literature search resulted in seven studies being critically appraised in this review ( Fig . ).…”

“…The studies were published between 2007 and 2015. They comprised seven cohort studies ( Table ) of which three were prospective. Original breast surgery was predominantly breast conservation; axillary surgery demonstrated greater variation between studies ( Table ).…”

“…Six studies, comprising 997 patients, provided data on the sentinel node identification rate on preoperative lymphoscintigraphy. A sentinel node was identified in a total of 631 patients, providing a pooled mean sentinel node identification rate on preoperative lymphoscintigraphy of 63·3 (95 per cent c.i.…”

“…60·3 to 66·3) per cent. Four studies provided data on the impact of previous surgery (SNB versus ALND) on sentinel node identification ( Fig. a ).…”

“…A total of seven studies, comprising 1053 patients, contributed to the intraoperative sentinel node identification rate. A sentinel node was identified in a total of 628 patients, providing a pooled mean intraoperative identification rate of 59·6 (56·7 to 62·6) per cent.…”