Dinçer Burak, Has Şimşek Duygu, Emiroğlu Selman, Tükenmez Mustafa, Müslümanoğlu Mahmut, Cabıoğlu Neslihan
University of Health Sciences Türkiye, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Clinic of Surgical Oncology, Ankara, Türkiye.
İstanbul University, İstanbul Faculty of Medicine, Clinic of Nuclear Medicine, İstanbul, Türkiye.
Mol Imaging Radionucl Ther. 2025 Jun 3;34(2):122-128. doi: 10.4274/mirt.galenos.2025.15932.
In patients with ipsilateral breast tumor recurrence (IBTR), lymphatic drainage may be altered due to factors such as prior axillary surgery and radiotherapy, thereby increasing the likelihood of sentinel lymph nodes (SLNs) in atypical locations. This study aimed to evaluate patients who underwent surgery for IBTR with lymphoscintigraphy for repeat SLN biopsy (re-SLNB), and to investigate the role of lymphoscintigraphy in re-SLNB in this patient group.
Patients diagnosed with IBTR who were evaluated using preoperative lymphoscintigraphy and subsequently underwent surgery were included in the study. Patients with systemic or nodal metastases, as well as those who did not undergo lymphoscintigraphy, were excluded. Demographic, clinical, and pathological data of the included patients were analyzed.
A total of 16 patients were evaluated, with a median age of 56 years (range 30-73), all of whom were female. Lymphoscintigraphy successfully localized the SLN in 81.3% of the patients. In eight patients, the SLN was located in the ipsilateral axilla, while in five patients, it was found in the contralateral axilla. Axillary lymph node dissection (ALND) was performed in three patients (all in the contralateral axilla) due to metastatic involvement in the SLN. ALND during first surgery was associated with an increased likelihood of SLN detection in the contralateral axilla or Re-SLNB failure (p=0.043).
In patients undergoing surgery for IBTR, the likelihood of the SLN being in atypical locations is high. Lymphoscintigraphy may enhance the success of Re--SLNB in this patient group.
在同侧乳腺肿瘤复发（IBTR）患者中，由于先前腋窝手术和放疗等因素，淋巴引流可能会改变，从而增加前哨淋巴结（SLN）位于非典型位置的可能性。本研究旨在评估接受IBTR手术并行淋巴闪烁显像以进行重复前哨淋巴结活检（re-SLNB）的患者，并探讨淋巴闪烁显像在该患者群体re-SLNB中的作用。
纳入术前接受淋巴闪烁显像评估并随后接受手术的IBTR诊断患者。排除有全身或淋巴结转移的患者以及未接受淋巴闪烁显像的患者。分析纳入患者的人口统计学、临床和病理数据。
共评估了16例患者，中位年龄56岁（范围30-73岁），均为女性。淋巴闪烁显像在81.3%的患者中成功定位了SLN。8例患者的SLN位于同侧腋窝，5例患者的SLN位于对侧腋窝。3例患者（均在对侧腋窝）因SLN有转移而进行了腋窝淋巴结清扫（ALND）。首次手术时进行ALND与对侧腋窝SLN检测或re-SLNB失败的可能性增加相关（p=0.043）。
在接受IBTR手术的患者中，SLN位于非典型位置的可能性很高。淋巴闪烁显像可能会提高该患者群体re-SLNB的成功率。
