Axillary Sentinel Lymph Node Biopsy for Breast Cancer and Melanoma Patients after Previous Axillary Surgery: A Systematic Review

作     者：Maurice Matter Sebastien Romy Ariane Boubaker Olivier Michielin Nicolas Demartines 

作者机构：Department of Nuclear Medicine Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland Department of Oncology Melanoma Outpatient Clinic Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland Department of Visceral Surgery Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland 

出 版 物：《Journal of Cancer Therapy》 (癌症治疗（英文）)

年 卷 期：2013年第4卷第9期

页      面：1395-1402页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Breast Neoplasms Melanoma Sentinel Lymph Node Biopsy Dissection Lymphatic Vessels Surgery Lymphatic Anatomy 

摘      要：Objective: Sentinel lymph node biopsy (SLNB) is a validated staging technique for breast carcinoma. Some women are exposed to have a second SLNB due to breast cancer recurrence or a second neoplasia (breast or other). Due to modified anatomy, it has been claimed that previous axillary surgery represents a contra-indication to SLNB. Our objective was to analyse the literature to assess if a second SLNB is to be recommended or not. Methods: For the present study, we performed a review of all published data during the last 10 years on patients with previous axilla surgery and second SLNB. Results: Our analysis shows that second SLNB is feasible in 70%. Extra-axillary SNs rate (31%) was higher after radical lymph node dissection (ALND) (60% - 84%) than after SLNB alone (14% - 65%). Follow-up and complementary ALND following negative and positive second SLNB shows that it is a reliable procedure. Conclusion: The review of literature confirms that SLNB is feasible after previous axillary dissection. Triple technique for SN mapping is the best examination to highlight modified lymphatic anatomy and shows definitively where SLNB must be performed. Surgery may be more demanding as patients may have more frequently extra-axillary SN only, like internal mammary nodes. ALND can be avoided when second SLNB harvests negative SNs. These conclusions should however be taken with caution because of the heterogeneity of publications regarding SLNB and surgical technique.