Sentinel lymph node biopsy performed under local anesthesia is feasible.
BACKGROUND
A sentinel lymph node (SLN) biopsy in breast cancer patients, performed under local anesthesia (LA), could have advantages such as more efficient use of operating room time and pathologist time. It also provides a histologic diagnosis before definitive breast surgery is undertaken. The aim of this study was to assess feasibility by comparing the results of SLN procedures performed under LA versus general anesthesia (GA).


METHODS
The SLN procedure was performed in 50 consecutive outpatients and 167 inpatients with clinical T1-2N0 breast cancer while they were under LA and GA, respectively. The SLN detection rate, a comparison of mapped and harvested SLNs, was compared for both groups. The duration of the SLN biopsies performed under LA was also measured.


RESULTS
For both groups a median of 2 SLNs/patient were harvested. The detection rate was 1.00 for the LA group and 0.99 for the GA group. The learning curve for SLN procedures under LA showed a decrease in duration for the consecutive months (not significant).


CONCLUSIONS
SLN biopsy can be safely and adequately performed with the patient under LA. It allows early diagnosis of the lymph node status, acquired on an outpatient basis, with minimal discomfort to the patient. The learning curve demonstrated that the LA procedure can quickly be mastered if the surgeon is experienced in performing SLN biopsies.
Smidt
Marjolein L
ML
Department of General Surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. m.smidt@chir.umcn.nl
Janssen
Caroline M M
CM
Barendregt
Wout B
WB
Wobbes
Theo
T
Strobbe
Luc J A
LJ
D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D000779:Anesthetics, Local; D001943:Breast Neoplasms / Q000473:pathology; D016022:Case-Control Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008012:Lidocaine; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy
D000779:Anesthetics, Local; D008012:Lidocaine