Our Summary

This research paper examines a surgical treatment for early breast cancer. The technique, called sentinel lymph node biopsy (SNB), allows doctors to avoid removing axillary (underarm) lymph nodes while still keeping the disease under control in that area.

The study looked back at data from 52 patients who had a repeat SNB (reSNB) after their initial breast surgery at the Kanagawa Cancer Center between June 2012 and March 2019. The reSNB was done using dye and radioactive methods to help identify the sentinel lymph nodes.

The researchers found that the reSNB technique was successful in identifying the sentinel lymph nodes in 94.2% of cases. Patients who had the SNB technique used in their initial surgery had a higher success rate with reSNB than those who had the axillary lymph nodes removed.

Only three patients (6.7%) showed positive signs of the disease in the underarm area on the same side as the initial tumor. No signs of the disease were found in the underarm area on the opposite side nor in the chest region. Also, there was no local recurrence in the underarm area on the same side as the initial tumor.

In simpler terms, the study suggests that the reSNB technique may be a promising method for managing recurring breast cancer, even though the number of cases studied was small. The technique was successful in identifying the key lymph nodes, had a low rate of the disease spreading, and no local recurrence in the underarm area on the same side as the initial tumor.

FAQs

  1. What is a sentinel lymph node biopsy (SNB)?
  2. What were the findings of the study conducted on sentinel lymph node biopsy (SNB) for early breast cancer patients?
  3. How effective is the reSNB method in identifying metastasis according to the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sentinel lymph node biopsy is to ensure they follow all pre-operative instructions, such as avoiding eating or drinking after midnight before the procedure. It is also important for the patient to discuss any medications they are taking with their doctor to ensure there are no interactions that could affect the biopsy. Additionally, the doctor may advise the patient to avoid strenuous activities after the procedure to allow for proper healing.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy include those with early breast cancer (cN0) who are undergoing breast-conserving surgery. Additionally, patients who may benefit from sentinel lymph node biopsy are those who have not undergone axillary lymph node dissection and have a low risk of axillary nodal involvement. These patients may include those with smaller tumors, no clinical evidence of lymph node involvement, and a favorable tumor biology. Patients who have ipsilateral breast tumor recurrence after initial breast-conserving surgery may also be recommended for sentinel lymph node biopsy to assess for axillary nodal involvement.

Timeline

Before sentinel lymph node biopsy:

  1. Patient is diagnosed with early breast cancer
  2. Patient undergoes initial breast-conserving surgery
  3. Patient may have imaging studies to determine lymph node involvement
  4. Patient discusses treatment options with their healthcare team, including the possibility of sentinel lymph node biopsy

After sentinel lymph node biopsy:

  1. Patient undergoes sentinel lymph node biopsy procedure using dye and radioactive isotope methods
  2. Sentinel lymph nodes are identified and removed for examination
  3. Results of the biopsy are analyzed to determine if there is any lymph node involvement
  4. If metastasis is detected, further treatment options may be discussed, such as axillary lymph node dissection
  5. Patient may undergo additional procedures, such as reSNB for ipsilateral breast tumor recurrence
  6. Follow-up monitoring is conducted to assess for any recurrence or complications
  7. Overall, reSNB demonstrates high identification rates and low rates of positive metastasis, suggesting its clinical significance in certain cases of breast cancer recurrence.

What to Ask Your Doctor

  1. What is a sentinel lymph node biopsy (SNB) and why is it recommended for my situation?
  2. What are the potential risks and benefits of undergoing a SNB?
  3. How is a SNB performed and what can I expect during the procedure?
  4. What is the likelihood of identifying sentinel lymph nodes during the biopsy?
  5. What happens if the sentinel lymph nodes are found to contain cancer cells?
  6. How does a reSNB differ from an initial SNB?
  7. What are the chances of experiencing a recurrence after undergoing a reSNB?
  8. Are there any alternative options to a reSNB that I should consider?
  9. How will the results of the reSNB impact my treatment plan moving forward?
  10. Are there any long-term implications or considerations I should be aware of after undergoing a reSNB?

Reference

Authors: Matsubara Y, Suganuma N, Nakamoto S, Kikawa Y, Iwamoto T, Yamanaka T, Yoshida T, Yamashita T, Saitou A. Journal: Breast Cancer. 2025 May;32(3):512-519. doi: 10.1007/s12282-025-01679-6. Epub 2025 Feb 13. PMID: 39939473