RE-SENTINEL NODE BIOPSY IN PATIENTS WITH IPSILATERAL BREAST CANCER RECURRENCE AFTER BREAST CONSERVING SURGERY sugihara_rie@kurume-u.ac.jp

3103-12

RE-SENTINEL NODE BIOPSY IN PATIENTS WITH IPSILATERAL BREAST CANCER RECURRENCE AFTER BREAST CONSERVING SURGERY

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Japan

Oral or Poster

We reviewed the clinical outcomes of salvage surgery and adjuvant therapies for management of patients with ipsilateral recurrent breast cancer (irBC).

Among 289 patients with early-stage breast cancer who underwent partial mastectomy (Bp) between 2015 and 2024, six (2.1%) developed postoperative irBC. Patient characteristics at initial diagnosis and recurrence were analyzed. Salvage surgical procedures and associated outcomes were evaluated.

Among the six patients, five had luminal B and one had triple-negative breast cancer (TNBC). The median time from initial surgery to recurrence was 68.5 months. Initial treatments included combinations of Bp, sentinel node biopsy (SNB), and axillary lymph node dissection (Ax). One TNBC patient with severe interstitial pneumonia underwent only lumpectomy without adjuvant therapies. For salvage surgery, five patients underwent mastectomy-three with repeat sentinel node biopsy (re-SNB), one with Ax level III dissection, and one with mastectomy alone. One patient had repeat lumpectomy. Re-SNB was performed using a triple tracer method (blue dye, ICG, and 99mTc colloid), identifying sentinel nodes ipsilaterally or contralaterally. No reirradiation was performed after salvage mastectomy. Over a median follow-up of 40.5 months, second recurrence occurred in three patients. Median disease-free survival was 27 months; overall survival was not reached.

Despite the small cohort and short follow-up, salvage surgery with re-SNB was feasible and effective for local control. However, the high rate of second recurrence highlights the need for comprehensive post-surgical management, including novel systemic therapies and selective reirradiation in high-risk patients.