Skip to main content

Advertisement

SpringerLink
Log in

Repeat Sentinel Lymph Node Biopsy for Ipsilateral Breast Tumor Recurrence: A Systematic Review of the Results and Impact on Prognosis

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

During recent years, an increasing number of patients with ipsilateral breast tumor recurrence (IBTR) and previous axillary surgery have undergone repeat sentinel lymph node biopsy (rSLNB). The influence of axillary nodal status on prognosis for IBTR patients remains unclear. This study aimed to evaluate the technical success rate, follow-up assessment, and prognostic value of rSLNB for patients with IBTR.

Methods

A systematic search conducted in MEDLINE, Embase, and the Cochrane Library up to July 2017 included all studies on rSLNB in IBTR.

Results

A total of 34 articles describing 1761 patients were identified. A repeat sentinel lymph node (rSLN) was successfully harvested from 64.3% of the patients with IBTR, and the rate was significantly higher for the patients who had a previous SLNB than for those who had a previous axillary lymph node dissection (ALND) (75.7% vs. 46.1%; P < 0.0001). The rSLN was tumor-positive for 18.2% of the rSLNs, 40% of which were harvested in basins other than the ipsilateral axilla. The negative predictive value of the rSLNB was 96.5%. Overall survival, reported for 21.5% of the patients, was 95.2% after a mean follow-up period of 29.6 months.

Conclusion

The prognostic impact of rSLN-positive versus rSLN-negative IBTR remains unclear. Further studies are needed to fill in the gap in the management of lymph nodes for patients with IBTR. However, based on the current evidence, rSLNB is feasible for 64% of patients, especially after previous SLNB. With a negative predictive value of 96.5%, rSLNB appears to be highly specific, with substantial advantages over ipsilateral ALND in IBTR.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.

    Article  PubMed  Google Scholar 

  2. Houssami N, Macaskill P, Marinovich ML, Morrow M. The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol. 2014;21:717–30.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Arriagada R, Le MG, Guinebretiere JM, Dunant A, Rochard F, Tursz T. Late local recurrences in a randomised trial comparing conservative treatment with total mastectomy in early breast cancer patients. Ann Oncol. 2003;14:1617–22.

    Article  CAS  PubMed  Google Scholar 

  4. Burger AE, Pain SJ, Peley G. Treatment of recurrent breast cancer following breast conserving surgery. Breast J. 2013;19:310–8.

    Article  PubMed  Google Scholar 

  5. Vugts G, Maaskant-Braat AJ, Voogd AC, et al. Repeat sentinel node biopsy should be considered in patients with locally recurrent breast cancer. Breast Cancer Res Treat. 2015;153:549–56.

    Article  CAS  PubMed  Google Scholar 

  6. Nationaal Borstkanker Overleg Nederland (NABON). Richtlijn behandeling van het mammacarcinoom. http://www.oncoline.nl. Accessed 2 Mar 2012.

  7. Lyman GH, Somerfield MR, Bosserman LD, Perkins CL, Weaver DL, Giuliano AE. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology Clinical practice guideline update. J Clin Oncol. 2016; 32: JCO1365

    Article  Google Scholar 

  8. Moossdorff M, van Roozendaal LM, Strobbe LJ, et al. Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research. J Natl Cancer Inst. 2014. doi: https://doi.org/10.1093/jnci/dju288

    PubMed  PubMed Central  Google Scholar 

  9. Intra M, Viale G, Vila J, et al. Second axillary sentinel lymph node biopsy for breast tumor recurrence: experience of the European Institute of Oncology. Ann Surg Oncol. 2015;22:2372–7.

    Article  CAS  PubMed  Google Scholar 

  10. Moossdorff M, Vugts G, Maaskant-Braat AJ, et al. Contralateral lymph node recurrence in breast cancer: regional event rather than distant metastatic disease: a systematic review of the literature. Eur J Surg Oncol. 2015;41:1128–36.

    Article  CAS  PubMed  Google Scholar 

  11. Morcos B, Jaradat I, El-Ghanem M. Characteristics of and therapeutic options for contralateral axillary lymph node metastasis in breast cancer. Eur J Surg Oncol. 2011;37:418–21.

    Article  CAS  PubMed  Google Scholar 

  12. Maaskant-Braat AJ, Voogd AC, Roumen RM, Nieuwenhuijzen GA. Repeat sentinel node biopsy in patients with locally recurrent breast cancer: a systematic review and meta-analysis of the literature. Breast Cancer Res Treat. 2013;138:13–20.

    Article  PubMed  Google Scholar 

  13. Lim I, Shim J, Goyenechea M, Kim CK, Krynyckyi BR. Drainage across midline to sentinel nodes in the contralateral axilla in breast cancer. Clin Nucl Med. 2004;29:346–7.

    Article  PubMed  Google Scholar 

  14. Sood A, Youssef IM, Heiba SI, et al. Alternative lymphatic pathway after previous axillary node dissection in recurrent/primary breast cancer. Clin Nucl Med. 2004;29:698–702.

    Article  PubMed  Google Scholar 

  15. Agarwal A, Heron DE, Sumkin J, Falk J. Contralateral uptake and metastases in sentinel lymph node mapping for recurrent breast cancer. J Surg Oncol. 2005;92:4–8.

    Article  PubMed  Google Scholar 

  16. Dinan D, Nagle CE, Pettinga J. Lymphatic mapping and sentinel node biopsy in women with an ipsilateral second breast carcinoma and a history of breast and axillary surgery. Am J Surg. 2005;190:614–7.

    Article  PubMed  Google Scholar 

  17. Tada K, Nishimura S, Miyagi Y, et al. The effect of an old surgical scar on sentinel node mapping in patients with breast cancer: a report of five cases. Eur J Surg Oncol. 2005;31:840–4.

    Article  CAS  PubMed  Google Scholar 

  18. Boughey JC, Ross MI, Babiera GV, et al. Sentinel lymph node surgery in locally recurrent breast cancer. Clin Breast Cancer. 2006;7:248–53.

    Article  PubMed  Google Scholar 

  19. Jackson BM, Kim S, Davidson R, Schuchter L, Acs G, Czerniecki BJ. Repeat operative sentinel lymph node biopsy. Clin Breast Cancer. 2006;6:530–4.

    Article  PubMed  Google Scholar 

  20. Newman EA, Cimmino VM, Sabel MS, et al. Lymphatic mapping and sentinel lymph node biopsy for patients with local recurrence after breast-conservation therapy. Ann Surg Oncol. 2006;13:52–7.

    Article  PubMed  Google Scholar 

  21. Roumen RMH, Kuijt GP, Liem IH. Lymphatic mapping and sentinel node harvesting in patients with recurrent breast cancer. Eur J Surg Oncol. 2006;32:1076–81.

    Article  CAS  PubMed  Google Scholar 

  22. Taback B, Nguyen P, Hansen N, Edwards GK, Conway K, Giuliano AE. Sentinel lymph node biopsy for local recurrence of breast cancer after breast-conserving therapy. Ann Surg Oncol. 2006;13:1099–104.

    Article  PubMed  Google Scholar 

  23. Barone JL, Feldman SM, Estabrook A, Tartter PI, Rosenbaum Smith SM, Boolbol SK. Reoperative sentinel lymph node biopsy in patients with locally recurrent breast cancer. Am J Surg. 2007;194:491–3.

    Article  PubMed  Google Scholar 

  24. Port ER, Garcia-Etienne CA, Park J, Fey J, Borgen PI, Cody IHS. Reoperative sentinel lymph node biopsy: a new frontier in the management of ipsilateral breast tumor recurrence. Ann Surg Oncol. 2007;14:2209–14.

    Article  PubMed  Google Scholar 

  25. Axelsson CK, Jonsson PE. Sentinel lymph node biopsy in operations for recurrent breast cancer. Eur J Surg Oncol. 2008;34:626–30.

    Article  CAS  PubMed  Google Scholar 

  26. Cox CE, Furman BT, Kiluk JV, et al. Use of reoperative sentinel lymph node biopsy in breast cancer patients. J Am Coll Surg. 2008;207:57–61.

    Article  PubMed  Google Scholar 

  27. Karam A, Stempel M, Cody HS III, Port ER. Reoperative sentinel lymph node biopsy after previous mastectomy. J Am Coll Surg. 2008;207:543–8.

    Article  PubMed  Google Scholar 

  28. Koizumi M, Koyama M, Tada K, et al. The feasibility of sentinel node biopsy in the previously treated breast. Eur J Surg Oncol. 2008;34:365–8.

    Article  CAS  PubMed  Google Scholar 

  29. Schrenk P, Tausch C, Wayand W. Lymphatic mapping in patients with primary or recurrent breast cancer following previous axillary surgery. Eur J Surg Oncol. 2008;34:851–6.

    Article  CAS  PubMed  Google Scholar 

  30. Tasevski R, Gogos AJ, Mann GB. Reoperative sentinel lymph node biopsy in ipsilateral breast cancer relapse. Breast. 2009;18:322–6.

    Article  CAS  PubMed  Google Scholar 

  31. van der Ploeg IM, Oldenburg HS, Rutgers EJ, et al. Lymphatic drainage patterns from the treated breast. Ann Surg Oncol. 2010;17:1069–75.

    Article  PubMed  Google Scholar 

  32. Vicente DA, Henry LR, Hahm G, Soballe PW, Smart D. Axillary sentinel lymph node biopsy after mastectomy: a case report. World J Surg Oncol. 2010;8:59

    Article  PubMed  PubMed Central  Google Scholar 

  33. Derkx F, Maaskant-Braat AJ, van der Sangen MJ, et al. Staging and management of axillary lymph nodes in patients with local recurrence in the breast or chest wall after a previous negative sentinel node procedure. Eur J Surg Oncol. 2010;36:646–51.

    Article  CAS  PubMed  Google Scholar 

  34. Yamashita T, Fujita T, Hayashi H, et al. Detection of parasternal metastatic lymph nodes by sentinel lymph node methods in a patient with recurrence in the conserved breast. Breast Cancer Tokyo Jpn. 2014;21:246–8.

    Article  Google Scholar 

  35. Hattori M, Nishimura S, Tada K, et al. Reoperative sentinel lymph node biopsy for ipsilateral breast tumor recurrence after previous axillary lymph node dissection: report of a case. Surg Today. 2011;41:247–50.

    Article  PubMed  Google Scholar 

  36. Kaur P, Kiluk JV, Meade T, et al. Sentinel lymph node biopsy in patients with previous ipsilateral complete axillary lymph node dissection. Ann Surg Oncol. 2011;18:727–32.

    Article  PubMed  Google Scholar 

  37. Tokmak H, Kaban K, Muslumanoglu M, Demirel M, Aktan S. Management of sentinel node re-mapping in patients who have second or recurrent breast cancer and had previous axillary procedures. World J Surg Oncol. 2014;12:205.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Cordoba O, Perez-Ceresuela F, Espinosa-Bravo M, et al. Detection of sentinel lymph node in breast cancer recurrence may change adjuvant treatment decision in patients with breast cancer recurrence and previous axillary surgery. Breast. 2014;23:460–5.

    Article  PubMed  Google Scholar 

  39. Matsumoto A, Jinno H, Takahashi M, Hayashida T, Kitagawa Y. Technical feasibility and validity of sentinel lymph node biopsy after ipsilateral breast tumor recurrence. Eur J Surg Oncol. 2016;42:S132.

    Article  Google Scholar 

  40. Uth CC, Christensen MH, Oldenbourg MH, et al. Sentinel lymph node dissection in locally recurrent breast cancer. Ann Surg Oncol. 2015;22:2526–31.

    Article  PubMed  Google Scholar 

  41. Karanlik H, Ozgur I, Kilic B, et al. Sentinel lymph node biopsy and aberrant lymphatic drainage in recurrent breast cancer: findings likely to change treatment decisions. J Surg Oncol. 2016;114:796–802.

    Article  PubMed  Google Scholar 

  42. Borrelli P, Donswijk ML, Stokkel MP, et al. Contribution of SPECT/CT for sentinel node localization in patients with ipsilateral breast cancer relapse. Eur J Nucl Med Mol Imaging. 2017;44:630–7.

    Article  PubMed  Google Scholar 

  43. Folli S, Falco G, Mingozzi M, et al. Repeat sentinel lymph node biopsy in patients with ipsilateral recurrent breast cancer after breast-conserving therapy and negative sentinel lymph node biopsy: a prospective study. Minerva Chir. 2016;71:73–9.

    PubMed  Google Scholar 

  44. Johnson J, Esserman L, Ewing C, Alvarado M, Park C, Fowble B. Sentinel lymph node mapping in post-mastectomy chest wall recurrences: influence on radiation treatment fields and outcome. Ann Surg Oncol. 2016;23:715–21.

    Article  PubMed  Google Scholar 

  45. Fisher B, Anderson S, Fisher ER, et al. Significance of ipsilateral breast tumour recurrence after lumpectomy. Lancet. 1991;338:327–31.

    Article  CAS  PubMed  Google Scholar 

  46. Veronesi U, Marubini E, Del Vecchio M, et al. Local recurrences and distant metastases after conservative breast cancer treatments: partly independent events. J Natl Cancer Inst. 1995;87:19–27.

    Article  CAS  PubMed  Google Scholar 

  47. Wapnir IL, Aebi S, Geyer CE, et al. A randomized clinical trial of adjuvant chemotherapy for radically resected locoregional relapse of breast cancer: IBCSG 27-02, BIG 1-02, and NSABP B-37. Clin Breast Cancer. 2008;8:287–92.

    Article  PubMed  Google Scholar 

  48. Anderson SJ, Wapnir I, Dignam JJ, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical adjuvant breast and bowel project protocols of node-negative breast cancer. J Clin Oncol. 2009;27:2466–73.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Voogd AC, van Oost FJ, Rutgers EJ, et al. Long-term prognosis of patients with local recurrence after conservative surgery and radiotherapy for early breast cancer. Eur J Cancer. 2005;41:2637–44.

    Article  CAS  PubMed  Google Scholar 

  50. Wapnir IL, Anderson SJ, Mamounas EP, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in five National surgical adjuvant breast and bowel project node-positive adjuvant breast cancer trials. J Clin Oncol. 2006;24:2028–37.

    Article  PubMed  Google Scholar 

  51. Kothari MS, Rusby JE, Agusti AA, MacNeill FA. Sentinel lymph node biopsy after previous axillary surgery: a review. Eur J Surg Oncol. 2012;38:8–15.

    Article  CAS  PubMed  Google Scholar 

  52. Ikeda T. Re-sentinel node biopsy after previous breast and axillary surgery. Surg Today. 2014;44:2015–21.

    Article  PubMed  Google Scholar 

  53. Vugts G, Maaskant-Braat AJ, Voogd AC, et al. Improving the success rate of repeat sentinel node biopsy in recurrent breast cancer. Ann Surg Oncol. 2015;22(Suppl 3):S529–35.

    Article  PubMed  Google Scholar 

  54. Valdes-Olmos RA, Jansen L, Hoefnagel CA, et al. Evaluation of mammary lymphoscintigraphy by a single intratumoral injection for sentinel node identification. J Nucl Med. 2000;41:1500–6.

    CAS  PubMed  Google Scholar 

  55. Ugras S, Matsen C, Eaton A, Stempel M, Morrow M, Cody HS. Reoperative sentinel lymph node biopsy is feasible for locally recurrent breast cancer, but is it worthwhile? Ann Surg Oncol. 2016;23:744–8.

    Article  PubMed  Google Scholar 

  56. Aebi S, Gelber S, Anderson SJ, et al. Chemotherapy for isolated locoregional recurrence of breast cancer (CALOR): a randomised trial. Lancet Oncol. 2014;15:156–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgment

The research conducted for this study complies with the current laws of The Netherlands.

Disclosures

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands

    Ingrid G. M. Poodt MD, Guusje Vugts MD, PhD, Robert-Jan Schipper MD, PhD & Grard A. P. Nieuwenhuijzen MD, PhD

Authors
  1. Ingrid G. M. Poodt MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guusje Vugts MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert-Jan Schipper MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Grard A. P. Nieuwenhuijzen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ingrid G. M. Poodt MD.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 385 kb)

Appendix 1

Appendix 1

Search Terms

PubMed/MEDLINE

((((((ipsilateral breast tumor recurrence) OR locally recurrent breast cancer) OR recurrent breast cancer)) AND (((“Sentinel Lymph Node Biopsy”[Mesh]) OR sentinel lymph node biopsy) OR lymphatic mapping))) OR (((((“Sentinel Lymph Node Biopsy”[Mesh]) OR sentinel lymph node biopsy) OR lymphatic mapping)) AND ((repeat) OR re-operative)).

Embase

(((sentinel lymph node biopsy/ OR sentinel lymph node biopsy.af. OR lymphatic mapping.af.) AND (recurrent breast cancer.af. OR ipsilateral breast tumor recurrence.af. OR locally recurrent breast cancer.af.)) OR ((sentinel lymph node biopsy/ OR sentinel lymph node biopsy.af. OR lymphatic mapping.af.) AND (repeat.af. OR reoperative.af.))).

Cochrane

((MeSH descriptor: [Sentinel Lymph Node Biopsy] explode all trees) OR “lymphatic mapping” OR “sentinel lymph node biopsy”) AND (“ipsilateral breast tumor recurrence” OR “recurrent breast cancer” OR “locally recurrent breast cancer”)) OR ((MeSH descriptor: [Sentinel Lymph Node Biopsy] explode all trees) OR “lymphatic mapping” OR “sentinel lymph node biopsy”) AND (“repeat” OR “re-operative”))

Information Data Extraction

The following information was collected:

  1. 1.

    Number of patients with locally recurrent breast cancer

  2. 2.

    Primary breast treatment: mastectomy or breast-conserving therapy/lumpectomy

  3. 3.

    Primary axillary treatment: sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND), or none

  4. 4.

    Adjuvant radiotherapy after primary event

  5. 5.

    Disease-free interval (DFI)

  6. 6.

    Secondary breast treatment: salvage mastectomy or second lumpectomy

  7. 7.

    Lymphatic mapping and repeat SLNB (rSLNB) technical success rate

  8. 8.

    Aberrant drainage patterns

  9. 9.

    Number of aberrant lymph nodes with metastases

  10. 10.

    Pathologic outcome rSLNB

  11. 11.

    Completion ALND and pathologic outcome

  12. 12.

    Adjuvant treatment after recurrence

  13. 13.

    Follow-up time in months

  14. 14.

    Regional recurrence rate

  15. 15.

    Distant recurrence rate

  16. 16.

    Survival

Review Questions

With the extracted data, an attempt was made to answer the following questions:

  1. 1.

    What is the identification rate for a repeat sentinel lymph node (rSLN) on preoperative lymphoscintigraphy?

  2. 2.

    What is the technical success rate for the repeat sentinel lymph node biopsy (rSLNB) procedure?

  3. 3.

    What is the location and pathologic outcome of the rSLN?

  4. 4.

    What is the influence of the previous axillary staging method (SLNB, axillary lymph node dissection [ALND], no axillary staging) on the identification rate of an rSLN on preoperative lymphoscintigraphy, the technical success rate of rSLNB, and aberrant drainage patterns?

  5. 5.

    What is the false-negative rate and the negative predictive value of rSLNB?

  6. 6.

    What is the probability of additional metastatic lymph nodes after a positive rSLN in completion ALND (cALND)?

  7. 7.

    Which adjuvant treatment plans were described after treatment of ipsilateral breast tumor recurrence (IBTR), and which adjuvant treatment plans were changed based on the outcome of the rSLNB procedure?

  8. 8.

    What percentage of patients are experiencing local, regional, and/or distant recurrences after rSLNB?

  9. 9.

    Is the pathologic lymph node status of patients with IBTR a prognostic factor?

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Poodt, I.G.M., Vugts, G., Schipper, RJ. et al. Repeat Sentinel Lymph Node Biopsy for Ipsilateral Breast Tumor Recurrence: A Systematic Review of the Results and Impact on Prognosis. Ann Surg Oncol 25, 1329–1339 (2018). https://doi.org/10.1245/s10434-018-6358-0

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-018-6358-0

Keywords

Search

Navigation