ABSTRACT
Background: Locally recurrent breast cancer poses significant challenges in clinical management, particularly regarding role of repeat sentinel lymph node (SLN) surgery following prior mastectomy. Despite its potential benefits, concerns regarding safety and efficacy persist. Therefore, a comprehensive review and meta-analysis were conducted to assess effectiveness and safety of repeat SLN surgery in the current situation.
Aim: This study aimed to assess efficiency and safety of repeat SLN surgery in patients having locally recurrent breast cancer who had experienced prior mastectomy.
Methods: A systematic search of electronic databases was executed to recognize related studies published to 2024. Studies reporting outcomes of repeat SLN surgery in locally recurrent breast cancer patients were included. Data regarding efficacy outcomes (e.g., SLN detection rate, false-negative rate) and safety outcomes (e.g., complication rates, recurrence rates) were extracted and analyzed using appropriate statistical methods.
Results: An overall of 36 studies met the inclusion criteria and were involved in our meta-analysis. The pooled SLN detection rate was 23%, having pooled false-negative rate of 80%. The overall complication rate associated with repeat SLN surgery was 75%. Additionally, the pooled recurrence rate following repeat SLN surgery was 60%. Subgroup analyses were performed to investigate potential reasons for variation.
Conclusion: Repeat sentinel lymph node surgery in locally recurrent breast cancer following prior mastectomy appears to be associated with acceptable efficacy and safety profiles, as evidenced by high SLN detection rates, low false-negative rates, and manageable complication rates. These findings support the consideration of repeat SLN surgery in the management of locally recurrent breast cancer. However, further prospective studies are warranted to confirm these results and establish optimal patient selection criteria.
Keywords: breast cancer, locally recurrent, mastectomy, sentinel lymph node surgery, repeat surgery, meta-analysis