So it is somewhat understood that a sentinel node biopsy after lumpectomy or a previous sentinel is contraindicated considering that the lymphatic supply is compromised already and it can lead to false negative results. A myth or not?
it's a relative contraindication.
Previous breast surgery may disrupt the lymphatics from the tumor site to the axilla and this may lead to higher false negative results or failed procedures. This seems to be true for extensive breast surgery such as reduction mammoplasty or quadradenctomy but not for more conservative surgery or biopsy procedures.
Large volume excisional biopsy results in subsequent disruption of breast lymphatics, decreasing the likelihood of successful lymphatic mapping. Therefore, any nodes removed after an excisional biopsy may not actually be an accurate reflection of lymphatic drainage from the site of the primary tumor. High failed sentinel lymph node identification rates (up to a 7-fold increase) after excisional biopsy and a significantly higher lymphatic mapping failure rate was reported.
Therefore, it seems that any type of previous breast biopsy (including excisional biopsy) does not affect the accuracy or success rate of SLNB. It is however, warranted that injection of radio colloid or dye directly into the biopsy cavity should be avoided since it may cause spillage and inaccurate lymphatic mapping.
I agree, it may difficult its localization but It does not contraindicate it
1. Previous sentinel lymph node biopsy is contraindication.
2. Lumpectomy especially in upper outer quadrant/ Oncoplasty will disrupt the lymphatic channel and correct sentinel lymph node detection may get jeopardized!
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