Challenges in axillary treatment for primary and recurrent breast cancer

The Sentinel Node And Recurrent Breast Cancer (SNARB) study examined the applicability of repeated sentinel node biopsies in patients with locally recurrent breast cancer. This study found that sentinel node biopsies are safe and effective for patients who have undergone previous surgery in the breast and/or underarm region. This makes a standard axillary lymph node dissection, which has a high risk of postoperative complications, unnecessary for these patients. For more than half of the patients in the SNARB study (54.1%), the sentinel lymph node was not found in the underarm but in a different location (e.g. near the sternum, clavicle or in the other underarm). When carrying out repeated sentinel node biopsies, it's important to inject a higher quantity of radioactive fluid in the right location to increase the chances of detecting the sentinel lymph node. In 80.1% of patients, the sentinel lymph node was tumour-free and no further treatment was necessary.