Improving the Success Rate of Repeat Sentinel Node Biopsy in Recurrent Breast Cancer

Vugts, Guusje; Maaskant‐Braat, A. J. G.; Voogd, Adri C.; Riet, Yvonne E A van; Roumen, R. M. H.; Luiten, Ernest J. T.; Rutgers, Emiel J.; Wyndaele, Dirk; Rutten, H.J.T.; Nieuwenhuijzen, Grard A. P.

doi:10.1245/s10434-015-4787-6

Cited by 20 publications

(13 citation statements)

References 25 publications

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“…As published before, injection with a larger amount of tracer leads to a higher identification rate. 32 In this study, patients with regional recurrence had a significantly lower amount of tracer injected. Injection of a higher tracer dose might have led to identification of repeat sentinel lymph nodes in additional basins.…”

Section: Discussionmentioning

confidence: 63%

Risk of Regional Recurrence After Negative Repeat Sentinel Lymph Node Biopsy in Patients with Ipsilateral Breast Tumor Recurrence

et al. 2018

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BackgroundRepeat sentinel lymph node biopsy (rSLNB) has increasingly been used in patients with ipsilateral breast tumor recurrence (IBTR). The safety in terms of regional disease control after this procedure remains unclear. This study evaluates occurrence of regional recurrence as first event in patients with IBTR and negative rSLNB, treated without additional lymph node dissection.Patients and MethodsData were obtained from the Sentinel Node and Recurrent Breast Cancer (SNARB) study. In 201 patients, tumor-negative rSLNB was obtained without performing additional lymph node dissections.ResultsWith median follow-up of 4.7 (range 0.9–12.7) years, regional recurrence occurred after median time of 3.0 (range 0.4–6.7) years in 4.5% (N = 9) of patients as first event after IBTR and rSLNB. In four of these nine patients, the site of recurrence was in concordance with the anatomical location of rSLNB. Two of the nine recurrences were reported in the ipsilateral axilla, resulting in an ipsilateral axillary regional recurrence rate of 1.0%. In the other seven patients, regional recurrence occurred in aberrant basins. Univariable analysis showed that triple-negative IBTR and lower amount of radioactive-labeled tracer (99mtechnetium) used during rSLNB were associated with developing regional recurrence as first event after negative rSLNB (P < 0.05).ConclusionsThe risk of developing regional recurrence after negative rSLNB is low. The low relapse rate supports the safety of rSLNB as primary nodal staging tool in IBTR. The time has come for clinical guidelines to adopt rSLNB as axillary staging tool in patients with IBTR.Electronic supplementary materialThe online version of this article (10.1245/s10434-018-6384-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 63%

Risk of Regional Recurrence After Negative Repeat Sentinel Lymph Node Biopsy in Patients with Ipsilateral Breast Tumor Recurrence

et al. 2018

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“…The SNARB study (Sentinel Node and Recurrent Breast Cancer) by Vugts et al, which is a multicenter study on the feasibility and clinical usefulness of the repeat SLNB, showed that the limited SLN visualization may be caused by previous radiotherapeutic treatment. In addition, it was advised to inject a larger amount of radioactive dye and a 1-day protocol for lymphoscintigraphy was proposed instead of the current 2-day protocol to increase the visualization rate [26]. Studies also show that the success rate of the SLN procedure increases when both the lymphoscintigraphy and Patent Blue methods are used and when a larger amount of radioactive dye is injected [23,[27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Non-visualized sentinel nodes in breast cancer patients; prevalence, risk factors, and prognosis

Verheuvel

Voogd

Tjan‐Heijnen

et al. 2017

Breast Cancer Res Treat

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“…The dual mapping technique with both 99m Tc and blue dye was used for the rSLNB procedure. Technical specifications and determinants of successful rSLNB have been reported in detail elsewhere.…”

Section: Methodsmentioning

confidence: 99%

“…In patients with an unsuccessful rSLNB, a sentinel node could not be visualized and/or harvested because of an unsuccessful procedure. In these patients, injection of a second dose of radiolabelled tracer was allowed, or the physician could act in accordance with the local protocol. There was no requirement to perform an ALND in patients with an unsuccessful rSLNB.…”

Section: Methodsmentioning

confidence: 99%

Prognostic impact of repeat sentinel lymph node biopsy in patients with ipsilateral breast tumour recurrence

Poodt

Vugts

Schipper

et al. 2019

British Journal of Surgery

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Background: Ipsilateral breast tumour recurrence (IBTR) has an unfavourable prognosis, with a significant subsequent risk of distant recurrence. Repeat sentinel lymph node biopsy (rSLNB) has recently been demonstrated to be technically feasible and useful in tailoring adjuvant treatment plans in patients with IBTR. The prognostic impact of rSLNB in patients with IBTR remains unclear. This study analysed the risk of distant recurrence after IBTR, and evaluated the prognostic impact of rSLNB and other patient and tumour characteristics on distant recurrence-free survival. Methods: Data were obtained from the SNARB (Sentinel Node and Recurrent Breast Cancer) study. Cox proportional hazards analyses were performed to assess the prognostic effect of tumour, patient and treatment factors on distant recurrence-free survival.Results: Of the 515 included patients, 230 (44⋅7 per cent) had a tumour-negative rSLNB and 46 (8⋅9 per cent) a tumour-positive rSLNB. In 239 patients (46⋅4 per cent) the rSLNB procedure was unsuccessful. After a median follow-up of 5⋅1 years, 115 patients (22⋅3 per cent) had developed a recurrence. The overall 5-year distant recurrence-free survival rate was 84⋅2 (95 per cent c.i. 80⋅7 to 87⋅7) per cent. An interval of less than 2 years between primary breast cancer treatment and ipsilateral recurrence (P = 0⋅018), triple-negative IBTR (P = 0⋅045) and absence of adjuvant chemotherapy after IBTR (P = 0⋅010) were independently associated with poor distant recurrence-free survival. The association between the outcome of rSLNB and distant recurrence-free survival was not statistically significant (P = 0⋅682). Conclusion:The outcome of rSLNB is not an important prognostic factor for distant recurrence, and its value as a staging tool in patients with IBTR seems disputable.Members of the SNARB study group are co-authors in this study and are listed in Appendix S1 (supporting information)

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Improving the Success Rate of Repeat Sentinel Node Biopsy in Recurrent Breast Cancer

Cited by 20 publications

References 25 publications

Risk of Regional Recurrence After Negative Repeat Sentinel Lymph Node Biopsy in Patients with Ipsilateral Breast Tumor Recurrence

Risk of Regional Recurrence After Negative Repeat Sentinel Lymph Node Biopsy in Patients with Ipsilateral Breast Tumor Recurrence

Non-visualized sentinel nodes in breast cancer patients; prevalence, risk factors, and prognosis

Prognostic impact of repeat sentinel lymph node biopsy in patients with ipsilateral breast tumour recurrence

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