Contralateral Axillary Sentinel Lymph Node Uptake for Local Recurrence of Breast Cancer after Breast Conservation Therapy

Abstract

Following breast conservation therapy for early breast cancer, about 10% of these patients will develop an ipsilateral breast tumor recurrence (IBTR) within 10 years after diagnosis. The benefits of sentinel lymph node (SLN) biopsy for these patients are still controversial. We present two patients with IBTR and contralateral axillary sentinel lymph nodes shown by preoperative lymphoscintigraphy. Patient 1 had breast conservation therapy and axillary lymph node dissection, and patient 2 had breast conservation therapy and SLN biopsy for primary cancer surgical intervention. These findings demonstrate the importance of lymphoscintigraphy in the preoperative evaluation of IBTR. Additionally, we should maintain a high index of suspicion that axillary metastatic lymph nodes could originate from a contralateral occult breast cancer by aberrant lymphatic drainage, especially after a contralateral breast or axillary surgical intervention.