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.
Sabel
Michael S
MS
Division of Surgical Oncology, University of Michigan Comprehensive Cancer Center, 3304 Cancer Center, 1500 E. Medical Center Dr, Ann Arbor, MI 48109, USA. msabel@umich.edu
Degnim
Amy
A
Wilkins
Edwin G
EG
Diehl
Kathleen M
KM
Cimmino
Vincent M
VM
Chang
Alfred E
AE
Newman
Lisa A
LA
D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D018567:Breast Neoplasms, Male / Q000601:surgery; D044584:Carcinoma, Ductal / Q000601:surgery; D018275:Carcinoma, Lobular / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D016462:Mammaplasty; D015413:Mastectomy, Simple; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy