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Sabel, M.S. et al.

Sabel, Degnim, Wilkins, Diehl, Cimmino, Chang, Newman,

Mastectomy and concomitant sentinel lymph node biopsy for invasive breast cancer.

BACKGROUND: Although sentinel lymph node biopsy (SNLB) has become a standard ancillary to breast conservation, there remains a hesitancy to perform SLNB concomitant with mastectomy primarily because of concerns regarding reoperation for a positive SLN. METHODS: A retrospective review of 51 patients who underwent SLN biopsy concomitantly with mastectomy for invasive breast cancer was performed. In addition, a survey was sent to surgical oncologists who routinely perform SLNB in conjunction with mastectomy. RESULTS: The SLN was identified in 98% of patients, and an average of 2.4 SLNs/patient were removed. The SLN was positive in 14 patients (27%). Ten patients underwent axillary lymph node dissection as a second procedure; an average of 15.4 +/- 6 nodes were cleared, and there were no complications. Although techniques vary greatly among surgeons, the majority believe that a subsequent ALND procedure does not carry additional risk of morbidity. CONCLUSIONS: Mastectomy and concomitant SLNB is a safe option for well-selected breast cancer patients. Results appear acceptable using a variety of techniques. Patients with a positive SLN can safely undergo completion axillary lymph node dissections. This includes patients who have undergone immediate reconstruction, but proper planning is needed to minimize potential risks.[1]

References

Mastectomy and concomitant sentinel lymph node biopsy for invasive breast cancer. Sabel, M.S., Degnim, A., Wilkins, E.G., Diehl, K.M., Cimmino, V.M., Chang, A.E., Newman, L.A. Am. J. Surg. (2004) [Pubmed]

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