Clinical Practice Guidelines for the Diagnosis, Treatment and Management of Breast Cancer

Dear Colleagues,

Breast cancer is a significant health issue worldwide, and clinical practice guidelines (CPGs) for its diagnosis, treatment and management play a critical role in improving patient outcomes. This Special Issue aims to reflect on the current status of research on breast cancer CPGs, identify the core problems to be solved and promote the development and dissemination of evidence-based CPGs.

This Special Issue will cover a broad range of topics, including the development and evaluation of breast cancer CPGs, the impact of CPGs on patient outcomes and the challenges of implementing CPGs in clinical practice. The articles included in the issue need to provide insights into the current state of breast cancer CPGs, including their strengths and limitations, and highlight areas for improvement.

The main goal of this Special Issue is to raise awareness of the importance of evidence-based CPGs in breast cancer diagnosis, treatment and management. It will provide an opportunity for researchers, clinicians and patients to collaborate and share knowledge to improve the quality of breast cancer care.

Overall, this Special Issue on Clinical Practice Guidelines for the Diagnosis, Treatment and Management of Breast Cancer will be a valuable resource for healthcare professionals and stakeholders involved in breast cancer care. It will provide a comprehensive overview of the current state of breast cancer CPGs and highlight the need for ongoing research and collaboration to improve patient outcomes.

Dr. Roberto Cuomo
Dr. Luigi Marano
Dr. Donato Casella
Guest Editors

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• breast cancer
• clinical practice guideline
• diagnosis
• treatment
• management

Title: Sentinel Lymph Node Biopsy in patients with recurrent ipsilateral breast cancer: Surgical Management and Implications on adjuvant treatment and recurrence - A Retrospective Study
Authors: Ines Torras, Eduard Mension
Affiliation: Hospital Clínic de Barcelona
Abstract: Abstract: Introduction: Between 5-10% of breast cancer patients will experience locoregional recurrence. Most of these patients have undergone previous axillary surgery, either with sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Traditionally, ipsilateral ALND was recommended directly, but there is an increasing trend to re-perform SLNB in this patient group. Materials and Methods: A retrospective study including 52 patients diagnosed with ipsilateral local recurrence of ductal carcinoma in situ or invasive breast carcinoma without clinical or radiological evidence of axillary involvement, operated on between 2018-2022. Results: A total of 51 women and 1 man with a mean age of 51 years were studied. The mean disease-free interval was 11 years. The drainage rate was 83% (43/52), of which 83.7% (36/43) showed drainage to the ipsilateral axilla and 30.2% (13/43) showed aberrant drainage (internal mammary or contralateral axilla). The exclusive aberrant drainage rate was 26% (11/43). The SLNB success rate was 75% (38/51), being lower in the subgroup of patients with previous ALND compared to those with previous SLNB (56% vs 80.7%, p<0.05). The aberrant drainage rate was higher in patients with previous ALND (43% vs 25%, p=0.058) and inversely proportional to the number of nodes removed (p<0.05). SLNB from the aberrant pathway was performed in 7 patients. 15% (6/38) of patients had pathological nodes, leading to completion lymphadenectomy. The mean follow-up period was 3 years. There were 5 cases of recurrence, comprising 1 local, 1 regional, and 3 distant recurrences. 13.7% developed lymphedema requiring rehabilitative treatment. Conclusions: The results of this study demonstrate that re-SLNB is a feasible and applicable technique in locoregional recurrence of breast cancer.