Improving the Success Rate of Repeat Sentinel Node Biopsy in Recurrent XXXX .

@entity1 @entity1600 @entity0
PURPOSE: Repeat sentinel node biopsy (SNB) is an alternative to @entity1600 ( @entity1600 ) for axillary staging in recurrent @entity0 . This study was conducted to determine factors associated with technical success of repeat SNB. METHODS: A total of 536 @entity1 with locally recurrent nonmetastatic @entity0 underwent lymphatic mapping (LM) and repeat SNB in 29 Dutch hospitals. RESULTS: A total of 179 @entity1 previously underwent breast-conserving surgery (BCS) with SNB, 262 @entity1 BCS with @entity1600 and 61 @entity1 mastectomy, 35 with SNB and 26 with @entity1600 . Another 34 @entity1 underwent breast surgery without axillary interventions. A repeat sentinel node (SN) was identified in 333 @entity1 (62.1 %) and was successfully removed in 235 (53.5 %). The overall repeat SN identification rate was 62.1 %, varying from 35 to 100 % in the participating hospitals. Previous radiotherapy of the breast [odds ratio (OR) 0.16; 95 % confidence interval (CI) 0.03-0.84], subareolar tracer injection (OR 0.34; 95 % CI 0.16-0.73), and a 2-day LM protocol (OR 0.57; 95 % CI 0.33-0.97) after previous BCS were independently associated with failure of SN identification. Injection of a larger amount of tracer (>180 MBq) led to a higher identification rate (OR 4.40; 95 % CI 1.45-13.32). CONCLUSIONS: Repeat SNB is a technically feasible procedure for axillary staging in recurrent @entity0 @entity1 . Previous radiotherapy appears to be associated with failure of SN identification. Injection with a larger amount of tracer (>180 MBq) leads to a higher identification rate; subareolar injection and a 2-day LM protocol after previous BCS appear to be less adequate.
