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Reoperative sentinel lymph node biopsy in ipsilateral breast cancer relapse
The Breast, 10/28/09

Tasveski R et al. – Sentinel lymph node biopsy (SLNB) is controversial following ipsilateral breast tumour relapse (IBTR) and previous axillary surgery. This study retrospectively assessed the feasibility, outcomes and utility of this procedure.Reoperative SLNB is feasible. Lymphatic drainage patterns vary widely and preoperative LSG is vital to facilitate identification of sentinel nodes in unusual sites.

• Retrospect assessment of the the feasibility, outcomes and utility of this procedure
• 18 patients with IBTR who underwent reoperative SLNB identified
• 15 women previously undergone axillary lymph node dissection and 3 SLNB for breast cancer
• 12 of 16 patients underwent successful lymphoscintigraphy (LSG)

• Lymphatic drainage patterns varied widely - ipsilateral axilla (5), contralateral axilla (5), and ipsilateral internal mammary (5)
• 2 patients had drainage to more than 1 nodal basin
• 9 of 12 patients demonstrated drainage outside of ipsilateral axilla
• Reoperative SLNB successful in 12/18 of patients - 4 ipsilateral axilla, 1 ipsilateral internal mammary, 1 ipsilateral intramammary, 4 contralateral axilla
• 2 patients had sentinel nodes in multiple nodal basins
• Positive sentinel node was found in 1 successful case (contralateral axilla) and isolated tumour cells in two (1 contralateral axilla, 1 ipsilateral internal mammary)

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