TY - JOUR
T1 - Sentinel lymph node biopsy is feasible even after total mastectomy
AU - Intra, Mattia
AU - Veronesi, Paolo
AU - Gentilini, Oreste D.
AU - Trifirò, Giuseppe
AU - Berrettini, Anastasio
AU - Cecilio, Rafaela
AU - Colleoni, Marco
AU - Rietjens, Mario
AU - Luini, Alberto
AU - Pacanelli, Giovanni
AU - Veronesi, Umberto
PY - 2007/2/1
Y1 - 2007/2/1
N2 - Background: Previous mastectomy is unanimously considered to represent an absolute technical contraindication to sentinel lymph node biopsy (SLNB). Methods: Four patients who underwent total mastectomy and plastic reconstruction with prosthesis, developed, during the follow up, a unique invasive limited local subdermic recurrence amenable to surgical excision, with clinically negative axillary nodes. In all patients preoperative lymphoscintigraphy with subdermal injection of 99mTc-labeled colloidal particles correctly showed an axillary sentinel lymph node (SLN). Results: Metastases in SLN were detected in two patients, and a complete axillary dissection followed. The remaining two patients had a negative SLN and no axillary clearance was performed. Conclusions: In selected cases, the subdermal injection of radioisotope permits the identification of an axillary SLN, even in mastectomized patients. Despite SLNB in mastectomized patients being technically feasible, only a larger population and longer patient follow up could confirm its true predictive value. However, there are no anatomical or physiological reasons to exclude "a priori" this diagnostic opportunity.
AB - Background: Previous mastectomy is unanimously considered to represent an absolute technical contraindication to sentinel lymph node biopsy (SLNB). Methods: Four patients who underwent total mastectomy and plastic reconstruction with prosthesis, developed, during the follow up, a unique invasive limited local subdermic recurrence amenable to surgical excision, with clinically negative axillary nodes. In all patients preoperative lymphoscintigraphy with subdermal injection of 99mTc-labeled colloidal particles correctly showed an axillary sentinel lymph node (SLN). Results: Metastases in SLN were detected in two patients, and a complete axillary dissection followed. The remaining two patients had a negative SLN and no axillary clearance was performed. Conclusions: In selected cases, the subdermal injection of radioisotope permits the identification of an axillary SLN, even in mastectomized patients. Despite SLNB in mastectomized patients being technically feasible, only a larger population and longer patient follow up could confirm its true predictive value. However, there are no anatomical or physiological reasons to exclude "a priori" this diagnostic opportunity.
KW - Axillary sentinel lymph node biopsy
KW - Breast cancer
KW - Previous total mastectomy
KW - Tumor recurrence
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U2 - 10.1002/jso.20670
DO - 10.1002/jso.20670
M3 - Article
C2 - 17262724
AN - SCOPUS:33846922565
VL - 95
SP - 175
EP - 179
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
SN - 0022-4790
IS - 2
ER -