Reoperative sentinel lymph node biopsy after previous mastectomy Journal Article
| Authors: | Karam, A.; Stempel, M.; Cody, H. S. 3rd; Port, E. R. |
| Article Title: | Reoperative sentinel lymph node biopsy after previous mastectomy |
| Abstract: | Background: Sentinel lymph node (SLN) biopsy is the standard of care for axillary staging in breast cancer, but many clinical scenarios questioning the validity of SLN biopsy remain. Here we describe our experience with reoperative-SLN (re-SLN) biopsy after previous mastectomy. Study Design: Review of the SLN database from September 1996 to December 2007 yielded 20 procedures done in the setting of previous mastectomy. SLN biopsy was performed using radioisotope with or without blue dye injection superior to the mastectomy incision, in the skin flap in all patients. In 17 of 20 patients (85%), re-SLN biopsy was performed for local or regional recurrence after mastectomy. Results: Re-SLN biopsy was successful in 13 of 20 patients (65%) after previous mastectomy. Of the 13 patients, 2 had positive re-SLN, and completion axillary dissection was performed, with 1 having additional positive nodes. In the 11 patients with negative re-SLN, 2 patients underwent completion axillary dissection demonstrating additional negative nodes. One patient with a negative re-SLN experienced chest wall recurrence combined with axillary recurrence 11 months after re-SLN biopsy. All others remained free of local or axillary recurrence. Re-SLN biopsy was unsuccessful in 7 of 20 patients (35%). In three of seven patients, axillary dissection was performed, yielding positive nodes in two of the three. The remaining four of seven patients all had previous modified radical mastectomy, so underwent no additional axillary surgery. Conclusions: In this small series, re-SLN was successful after previous mastectomy, and this procedure may play some role when axillary staging is warranted after mastectomy. © 2008 American College of Surgeons. |
| Keywords: | adult; clinical article; human tissue; aged; middle aged; sentinel lymph node biopsy; neoplasm recurrence, local; mastectomy; breast neoplasms; data base; axillary lymph node; reoperation; radioisotope; time series analysis; thorax wall; skin flap |
| Journal Title: | Journal of the American College of Surgeons |
| Volume: | 207 |
| Issue: | 4 |
| ISSN: | 1072-7515 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2008-10-01 |
| Start Page: | 543 |
| End Page: | 548 |
| Language: | English |
| DOI: | 10.1016/j.jamcollsurg.2008.06.139 |
| PUBMED: | 18926457 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 12" - "Export Date: 17 November 2011" - "CODEN: JACSE" - "Source: Scopus" |
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