Abstract 92P
Background
According to various studies, local recurrence (LR) of breast cancer (BC) occurs in 3-20%. The standard surgical care is the removal of a recurrent tumor, but the issue of the extent of surgery on regional lymph nodes in case of local relapses has not been resolved.
Methods
In 2022 and 2023 at our institution we identified 27 patients with local recurrence of breast cancer. As primary surgery lumpectomy with axillary lymph node dissection (ALND) was performed in 13 patients (48.1%), lumpectomy with sentinel lymph node biopsy (SNB) - in 5 patients (18.5%), radical mastectomy - in 2 patients (7.4%), skin-sparing mastectomy with SNB - in 2 patients (7.4%), radical skin-sparing mastectomy – in 3 patients (11.1%). LR occurred between 2 and 22 years. Tc99m-labeled albumin nano colloid was injected subareolar (during previous organ-sparing surgery or subcutaneous mastectomy) or peritumoral (after mastectomy) the day before surgery, followed by scintigraphy on a single photon emission computed tomography (SPECT) for determination of SLN localization. Intraoperative SLN localization was performed using a portable gamma-detector.
Results
In 21 (77.8%) patients, SLN were detected and marked by SPECT. Intraoperatively, SLN were identified in 17 (62.9%) patients using a gamma-detector. The number of identified SLN ranged from 1 to 4 (median – 2). After previous lymphadenectomy, SLN were identified in 10 out of 20 patients (50.0%), after SLNB - in 7 out of 7 patients (100.0%). SLNs were found in the axilla in 14 (51.8%) patients, in the parasternal zone - in 1 (3.7%), in the contralateral axillary region - in 2 (7.4%) patients. Histological examination revealed metastatic lesions at the SLN in only 1 patient (3.7%), and this node was localized in the contralateral axilla.
Conclusions
Despite the low incidence of SLN metastasis in LR breast cancer (3.7% in our study), the treatment in these patients will be different. Further studies are needed to determine the feasibility of performing SLNB in patients with LR BC.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.