Mastectomy and concomitant sentinel lymph node biopsy for invasive breast cancer
Received 22 July 2003; received in revised form 17 October 2003
Abstract
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.
aDivision of Surgical Oncology, University of Michigan Comprehensive Cancer Center, 3304 Cancer Center, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
bDepartment of Plastic Surgery, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
ABSTRACT