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Three sentinel lymph node biopsies successfully performed in the same lymph nodal basin

Andraz Perhavec, Marko Hocevar, Nikola Besic, Barbara Vidergar, Janez Zgajnar

Am J Case Rep 2008; 9:53-56

ID: 744372

Background: The sentinel lymph node biopsy is a standard procedure for staging clinically node negative patients with early invasive breast cancer and melanoma. In case of new primary cancers or recurrent cancers a second sentinel lymph node biopsy was shown to be feasible in the same nodal basin. However, there are no reports of more than two consecutive sentinel lymph node biopsies in the same noda basin.
Case Report: We present and discuss the case of a 57 years old female who had three consecutive sentinel lymph node biopsies successfully performed in the same nodal basin. The first sentinel lymph node biopsy was performed for the melanoma on the back. Lymphoscintigraphic imaging revealed one sentinel lymph node in the right axilla, which was successfully removed. About one year later she presented with primary breast cancer. Again lymphoscintigraphy was performed and revealed three sentinel lymph nodes in the right axilla. All three sentinel lymph nodes were successfully removed. Three years later a recurrent breast cancer was diagnosed. Lymphosintigraphic imaging showed three sentinel lymph nodes, all three again in th  right axilla. During the operation five sentinel lymph nodes from the right axilla were found and removed.
Conclusions: This case report indicates that a second and even third sentinel lymph node biopsy in the same nodal basin is feasible and representative.

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