Low Risk of Development of a Regional Recurrence After an Unsuccessful Repeat Sentinel Lymph Node Biopsy in Patients with Ipsilateral Breast Tumor Recurrence

Autor: Poodt, Ingrid G. M., Walstra, Coco J. E. F., Vugts, Guusje, Maaskant-Braat, Adriana J. G., Voogd, Adri C., Schipper, Robert-Jan, Nieuwenhuijzen, Grard A. P., Roumen, R. M. H., Luiten, E. J. T., Rutgers, E. J. T., Vrancken-Peeters, M. T. F. D., Bessems, M., Klaase, M., Muller, S., Francken, A. B., Van Dalen, T., Jansen, L., Koopal, S. A., Vissers, Y. L. J., Smidt, M. L., Merkus, J. W. S., Contant, C. M. E., Veldman, P. H., Linthorst-Niers, E. M. H., van der Sijp, J. R., Guicherit, O. R., Koppert, L. B., Bosch, A. M., Strobbe, L. J. A., Schlooz-Vries, M. S., Arntz, I. E., van Essen, J. A., de Waard, J. W. D., Vrouenraets, B. C., van Ooijen, B.
Přispěvatelé: Developmental Psychology, Surgery, Epidemiologie, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Heelkunde (9)
Rok vydání: 2019
Předmět:
Adult
medicine.medical_specialty
SURGERY
medicine.medical_treatment
Sentinel lymph node
Regional Disease
Breast Neoplasms
Metastasis
03 medical and health sciences
0302 clinical medicine
Risk Factors
Biopsy
Medicine
FIBROSIS
Humans
Neoplasm Invasiveness
Aged
Aged
80 and over
medicine.diagnostic_test
business.industry
Sentinel Lymph Node Biopsy
Axillary Lymph Node Dissection
WOMEN
Sentinel node
Middle Aged
medicine.disease
EUROPEAN INSTITUTE
Prognosis
CANCER
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]
Radiation therapy
Axilla
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Lymphatic Metastasis
METASTASIS
Lymph Node Excision
030211 gastroenterology & hepatology
TRIAL
Female
Radiology
Neoplasm Recurrence
Local
Sentinel Lymph Node
business
RADIOTHERAPY
Follow-Up Studies
Zdroj: Annals of Surgical Oncology, 26, 2417-2427
Annals of Surgical Oncology, 26(8), 2417-2427. SPRINGER
Annals of Surgical Oncology, 26(8), 2417-2427. Springer New York
Annals of Surgical Oncology, 26(8), 2417-2427. Springer, Cham
Annals of Surgical Oncology, 26, 8, pp. 2417-2427
ISSN: 1068-9265
Popis: Item does not contain fulltext BACKGROUND: Unlike sentinel lymph node biopsy (SLNB) in the primary setting, the repeat SLNB (rSLNB) in patients with ipsilateral breast tumor recurrence (IBTR) is challenging, because it is difficult to visualize and/or harvest a sentinel lymph node in every patient. Regional treatments options and safety in terms of regional disease control after such an unsuccessful rSLNB remain unclear. This study assesses factors associated with the performance of axillary lymph node dissection (ALND) after unsuccessful rSLNB and evaluates the occurrence of regional recurrences. METHODS: Data were obtained from the Sentinel Node and Recurrent Breast Cancer (SNARB) study. In 239 patients, the rSLNB was unsuccessful, of whom 60 patients underwent ipsilateral ALND. RESULTS: A shorter time interval between primary treatment and IBTR, and a primary negative SLNB were significantly associated with a higher probability to be treated with ALND after unsuccessful rSLNB (P < 0.001). The 5-year regional-recurrence rate was 0.0% in the ALND group compared with 3.7% in the group treated without ALND (P = 0.113). Of the 179 patients treated without ALND, after a median follow-up of 5.1 years (range 0.3-13.2), 7 (3.9%) developed a regional recurrence as first event after unsuccessful rSLNB. None of the seven recurrences occurred in the ipsilateral axilla. Univariable analysis showed no factors associated with regional recurrence as first event after unsuccessful rSLNB (P > 0.05). CONCLUSIONS: The present study demonstrates that the risk of regional recurrence in patients with an IBTR and an unsuccessful rSLNB is negligible, irrespective of the use of ALND. This suggests that there is no need for additional treatment of the axilla after an unsuccessful rSLNB.
Databáze: OpenAIRE
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