The Role of redo-Sentinel Lymph Node Biopsy in Patients With Prior Ipsilateral Breast Cancer Surgery

This a retrospective study comparing redo-Sentinel Lymph Node Biopsy (reSLNB) and Axillary node sample looking at patients with recurrence with history of breast-conserving surgery. Our data shows that 35(72.9%) of reSLNB were successful with node positivity that is comparable to Axillary node sampling. reSLNB success rate was lower amongst patients with previous axillary surgery and previous positive nodes. Background: Sentinel Lymph Node Biopsy (SLNB) is used to stage the axilla, but there is limited data in patients with prior ipsilateral breast cancer. This study compares redo-SLNB (reSLNB) and Axillary node sample (ANS) in this sub-cohort of patients. Materials and Methods: This is a retrospective study looking at patients with a new ipsilateral primary or recurrence with history of breast-conserving surgery. Planned and performed surgery, patient demographics and previous treatments were recorded. Node positivity and success rate of reSLNB was analyzed. Results: A total of 86 patients were identified that had mastectomy for ipsilateral recurrent disease with radiologically negative axilla. Out of the 48 that had reSLNB, 35(72.9%) were successful. Nineteen percent of the reSLNB had positive axillae and 20% of the ANS patients. reSLNB success rate was significantly lower amongst patients with previous axillary surgery ( P = .014) and previous positive nodes( P = .001). Conclusion: reSLNB should be considered to restage the axilla in patients with previous history of ipsilateral cancer especially that there is growing evidence showing good identification rate.