R Haarsma1, A A van Loevezijn1,2, M L Donswijk3, A N Scholten4, M T F D Vrancken Peeters1,2, F H van Duijnhoven5. 1. Department of Surgical Oncology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Plesnmanlaan 121, 1066CX, Amsterdam, The Netherlands. 2. Department of Surgical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands. 3. Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands. 4. Department of Radiotherapy, Netherlands Cancer Institute- Antoni Van Leeuwenhoek, Amsterdam, The Netherlands. 5. Department of Surgical Oncology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Plesnmanlaan 121, 1066CX, Amsterdam, The Netherlands. f.v.duijnhoven@nki.nl.
Abstract
PURPOSE: Repeat sentinel lymph node biopsy (rSLNB) has been suggested for axillary staging in clinically node-negative (cN0) patients with ipsilateral breast tumor recurrence (IBTR). Although rSLNB is technically feasible in this group of patients, the clinical value has not been established. We aimed to assess the added value of rSLNB in cN0 patients with IBTR who underwent optimal clinical staging with FDG-PET/CT. METHODS: This retrospective single-center cohort study included 119 patients with IBTR-staged cT1-4N0M0 with FDG-PET/CT who underwent rSLNB between 2006 and 2020. Overall recurrence-free survival (RFS) and overall survival (OS) were calculated for subgroups with tumor-positive, tumor negative, and unsuccessful rSLNB. RESULTS: rSLNB was successful in 79 (66%) of the 119 included patients, of whom 70 (59%) had a tumor negative and 9 (8%) a tumor-positive rSLNB; rSLNB was unsuccessful in the remaining 40 (34%) patients. Patients with a tumor-positive rSLNB had poorer overall 5-year RFS compared to patients with a tumor negative or unsuccessful rSLNB (44% vs. 86% vs. 90%, p = 0.004). Although patients with a tumor-positive rSLNB had worse RFS, the 10-year OS was comparable to a tumor negative or unsuccessful rSLNB (89% vs. 89% vs. 95%, p = 0.701). CONCLUSION: The incidence of a tumor-positive rSLNB in patients with a negative FDG-PET/CT is low and does not change survival. Therefore, in cN0 patients with IBTR who underwent optimal clinical staging with FDG-PET/CT, we support a patient- and tumor-tailored treatment strategy in which rSLNB may be omitted.
PURPOSE: Repeat sentinel lymph node biopsy (rSLNB) has been suggested for axillary staging in clinically node-negative (cN0) patients with ipsilateral breast tumor recurrence (IBTR). Although rSLNB is technically feasible in this group of patients, the clinical value has not been established. We aimed to assess the added value of rSLNB in cN0 patients with IBTR who underwent optimal clinical staging with FDG-PET/CT. METHODS: This retrospective single-center cohort study included 119 patients with IBTR-staged cT1-4N0M0 with FDG-PET/CT who underwent rSLNB between 2006 and 2020. Overall recurrence-free survival (RFS) and overall survival (OS) were calculated for subgroups with tumor-positive, tumor negative, and unsuccessful rSLNB. RESULTS: rSLNB was successful in 79 (66%) of the 119 included patients, of whom 70 (59%) had a tumor negative and 9 (8%) a tumor-positive rSLNB; rSLNB was unsuccessful in the remaining 40 (34%) patients. Patients with a tumor-positive rSLNB had poorer overall 5-year RFS compared to patients with a tumor negative or unsuccessful rSLNB (44% vs. 86% vs. 90%, p = 0.004). Although patients with a tumor-positive rSLNB had worse RFS, the 10-year OS was comparable to a tumor negative or unsuccessful rSLNB (89% vs. 89% vs. 95%, p = 0.701). CONCLUSION: The incidence of a tumor-positive rSLNB in patients with a negative FDG-PET/CT is low and does not change survival. Therefore, in cN0 patients with IBTR who underwent optimal clinical staging with FDG-PET/CT, we support a patient- and tumor-tailored treatment strategy in which rSLNB may be omitted.
Authors: Tessa G Steenbruggen; Mette S van Ramshorst; Marleen Kok; Sabine C Linn; Carolien H Smorenburg; Gabe S Sonke Journal: Drugs Date: 2017-08 Impact factor: 9.546
Authors: Adriana J G Maaskant-Braat; Adri C Voogd; Rudi M H Roumen; Grard A P Nieuwenhuijzen Journal: Breast Cancer Res Treat Date: 2013-01-23 Impact factor: 4.872
Authors: G Vugts; A J G Maaskant-Braat; A C Voogd; Y E A van Riet; E J T Luiten; E J Th Rutgers; H J T Rutten; R M H Roumen; G A P Nieuwenhuijzen Journal: Breast Cancer Res Treat Date: 2015-09-10 Impact factor: 4.872
Authors: I G M Poodt; G Vugts; R J Schipper; R M H Roumen; H J T Rutten; A J G Maaskant-Braat; A C Voogd; G A P Nieuwenhuijzen Journal: Br J Surg Date: 2019-04 Impact factor: 6.939
Authors: M Intra; G Viale; J Vila; C M Grana; A Toesca; O Gentilini; V Galimberti; P Veronesi; A Luini; N Rotmensz; V Bagnardi; D Mattar; M Colleoni Journal: Ann Surg Oncol Date: 2014-12-17 Impact factor: 5.344
Authors: Marissa C van Maaren; Luc J A Strobbe; Marjolein L Smidt; Martine Moossdorff; Philip M P Poortmans; Sabine Siesling Journal: Eur J Cancer Date: 2018-08-23 Impact factor: 9.162
Authors: H Bonnefoi; S Litière; M Piccart; G MacGrogan; P Fumoleau; E Brain; T Petit; P Rouanet; J Jassem; C Moldovan; A Bodmer; K Zaman; T Cufer; M Campone; E Luporsi; P Malmström; G Werutsky; J Bogaerts; J Bergh; D A Cameron Journal: Ann Oncol Date: 2014-03-11 Impact factor: 32.976