Sentinel lymph node biopsy for breast cancer: The role of previous biopsy on patient eligibility

Several reports have demonstrated the accurate prediction of axillary nodal status with radiolocalization and selective resection of sentinel lymph no des (SLNs) in patients with breast cancer (BC). Because of concerns over ly mphatic disruption, several authors have proposed that prior excisional bre ast biopsy is a contraindication for SLN biopsy. Clear unfiltered (99m)tech netium-sulfur colloid (1.0 mCi) was injected around the perimeter of the br east lesion (palpable and nonpalpable) or prior biopsy site. Resection of t he radiolocalized SLN was then performed. Axillary lymph node dissection wa s performed immediately after SLN biopsy in the first 57 patients. Eighty-t wo BC patients underwent SLN biopsy. The SLN was localized in 98 per cent ( 80 of 82). The type of previously performed diagnostic biopsy or the locati on of the primary lesion did not influence the ability to localize the sent inel lymph node. In the 57 patients who had axillary lymph node dissection, metastatic disease was identified in 23 per cent (13 of 57). Axillary noda l status was accurately predicted in 98 per cent (56 of 57). Early experien ce with radiolocalization and selective resection of SLN in BC remains prom ising. By demonstrating the effective localization of the SLN regardless of the extent of prior biopsy, these data support expanding the number of pat ients potentially eligible for SLN biopsy.