Repeat SLN biopsy not prognostic in ipsilateral breast tumors

  • Poodt IGM & al.
  • Br J Surg
  • 1 Apr 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • The outcome of repeat sentinel lymph node biopsy (rSLNB) has no prognostic effect in patients with breast cancer with ipsilateral breast tumor recurrence (IBTR).

Why this matters

  • rSLNB is not useful as a staging tool or for developing treatment plans for IBTR.

Study design

  • Prospective cohort of 515 patients with breast cancer with IBTR in 36 Dutch hospitals participating in SNARB.
  • Outcome of rSLNB was tumor-positive, tumor-negative, or unsuccessful. 
    • A positive outcome was defined as lymph node containing either macrometastases (>2.0 mm) and/or micrometastases (>0.2 mm and/or >200 cells).
  • Primary outcome was outcome of rSLNB in relation to distant recurrence-free survival (RFS).
  • Funding: None disclosed.

Key results

  • rSLNB was tumor-negative in 44.7%, tumor-positive in 8.9%, and unsuccessful in 46.4%.
  • 22.3% of patients had developed a recurrence after a median follow-up of 5.1 years.
  • The overall 5-year distant RFS rate was 84.2% (95% CI, 80.7%-87.7%).
  • No association was found between outcome of rSLNB and distant RFS (P=.682).
  • Poor distant RFS was associated with:
    • An interval of
    • Triple-negative IBTR (HR, 1.82; P =.045).
    • Absence of adjuvant chemotherapy after IBTR (P =.010).

Limitations

  • Observational design.

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