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

Poodt, Ingrid G. M.; Vugts, Guusje; Maaskant‐Braat, A. J. G.; Schipper, Robert-Jan; Voogd, Adri C.; Nieuwenhuijzen, Grard A. P.

doi:10.1245/s10434-018-6384-y

Cited by 19 publications

(19 citation statements)

References 35 publications

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“…In patients with a positive rSLNB, the incidence of an aberrant node being the site of regional metastatic disease is fairly high, at approximately 40% (range 20-72%). [2][3][4] Poodt et al previously reported a low risk of regional recurrence in the setting of a negative SLNB, 5 and herein report a low risk of regional recurrence if lymphatic mapping fails. 1 Importantly, if there is a regional failure, many occur outside the ipsilateral axilla (supraclavicular, internal mammary and contralateral axilla).…”

supporting

confidence: 56%

Sentinel Lymph Node Biopsy for Ipsilateral Breast Tumor Recurrence, Technically Feasible but Influence on Oncologic Outcomes Yet to be Completely Defined

Jakub

2019

Ann Surg Oncol

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supporting

confidence: 56%

Sentinel Lymph Node Biopsy for Ipsilateral Breast Tumor Recurrence, Technically Feasible but Influence on Oncologic Outcomes Yet to be Completely Defined

Jakub

2019

Ann Surg Oncol

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“…In a meta‐analysis, the reported false‐negative rate of rSLNB was 4·1 per cent. The clinical ipsilateral recurrence rate after a negative rSLNB was 1·0 per cent after a follow‐up of 5·1 years. Thus, a false‐negative rSLNB seemed to be associated with clinically manifest recurrence in around 25 per cent of patients (1·0 per cent/4·1 per cent × 100).…”

Section: Discussionmentioning

confidence: 96%

“…Therefore, it was hypothesized that lymph node status determined by rSLNB could have the same role in patients with IBTR. In an earlier study, a low regional relapse rate for rSLNB‐negative patients treated without ALND suggested that omitting ipsilateral ALND was safe, and it was proposed that rSLNB should be adopted as standard of care in IBTR. Going further, the present study analysed the impact of any axillary staging in patients with IBTR.…”

Section: Discussionmentioning

confidence: 99%

“…A local re‐recurrence (LRR) after a previously treated IBTR was defined as reappearance of tumour growth in the treated breast or overlying skin. A regional recurrence (RR) was defined as any evidence of disease in ipsilateral intramammary nodes, ipsilateral and contralateral internal mammary nodes, ipsilateral and contralateral axillary nodes, and ipsilateral and contralateral infraclavicular and supraclavicular nodes. Lymph node recurrences outside these nodal basins were considered as distant metastatic disease.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have assessed repeat sentinel lymph node biopsy (rSLNB) in patients with IBTR, and reported that it is technically feasible and useful in tailoring adjuvant treatment plans. Regional relapse rates after negative rSLNB without completion ALND in patients with recurrent breast cancer are very low. However, detailed information on distant relapse rates is lacking and so the prognostic value of rSLNB remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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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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Prognostic value and management of regional lymph nodes in locoregional breast cancer recurrence: a systematic review of the literature

Erbes

Juhasz-Böss

2022

Arch Gynecol Obstet

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Purpose Management of regional lymph nodes in breast cancer recurrence has been heterogeneous. To facilitate clinical practice, this review aims to give an overview on the prognosis, staging and operative management of (inapparent) regional lymph nodes. Methods Current national and international guidelines are reviewed and a structured search of the literature between Jan 1, 1999 and Feb 1, 2021 on the repeat sentinel node biopsy (re-SNB) procedure was performed. Results Positive regional lymph nodes in recurrent breast cancer indicate a poorer outcome with axillary recurrences being the most favorable tumor site among all nodal regions. Most preferred staging method is ultrasound ± guided biopsy. PET-CT, scintimammography, SPECT-CT may improve visualization of affected lymph nodes outside the axilla. Concerning operative management 30 articles on re-SNB were identified with a mean harvesting rate of 66.4%, aberrant drainage and aberrant metastasis in 1/3 of the cases. Total rate of metastasis is 17.9%. After previous axillary dissection (ALND) the re-SNB has a significantly lower harvesting rate and higher aberrant drainage and aberrant metastasis rate. The prognostic outcome after re-SNB has been favorable. Conclusion Nodal status in recurrent disease has prognostic value. The choice of operative management of clinically inapparent regional lymph nodes during local recurrence should be based on the previous nodal staging method. Patients with previous ALND should be spared a second systematic ALND. Re-SNB or no axillary surgery at all are possible alternatives. Lymphoscintigraphy may be performed to identify extraaxillary drainage. However, for definite recommendations randomized controlled studies are heavily needed.

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

Cited by 19 publications

References 35 publications

Sentinel Lymph Node Biopsy for Ipsilateral Breast Tumor Recurrence, Technically Feasible but Influence on Oncologic Outcomes Yet to be Completely Defined

Sentinel Lymph Node Biopsy for Ipsilateral Breast Tumor Recurrence, Technically Feasible but Influence on Oncologic Outcomes Yet to be Completely Defined

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

Prognostic value and management of regional lymph nodes in locoregional breast cancer recurrence: a systematic review of the literature

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