title: The feasibility of sentinel lymph node detection in patients with previous transaxillary implant breast augmentation: preliminary results.
abstract: BACKGROUND
  Transaxillary breast augmentation has gained popularity because of the good aesthetic results and scar placement in a less visible position. As breast-augmented patients age, an increasing number of breast cancer cases can be expected. Sentinel lymph node detection (SLND) is a well-established technique in breast cancer. To date, no information is available regarding the feasibility of SLND for patients with previous transaxillary implants.
  
  
  METHODS
  A 28-year-old women with bilateral breast hypoplasia underwent a bilateral breast augmentation by the transaxillary approach. One week earlier, SLND was accomplished through two periareolar injections of 0.1 mCi 99m-technetium-labeled fitate and lymphoscintigraphy. A 3.5-cm-long axillary incision was performed, and the dissection continued through the subfascial plane to create the implant's pocket. A silicone gel implant (215 g round, low-profile, textured Silimed) was inserted.
  
  
  RESULTS
  A satisfactory aesthetic result was obtained. Two postoperative lymphoscintigraphies were performed (15 days and 7 months after surgery) with satisfactory SLND. No complication was noted.
  
  
  CONCLUSIONS
  The initial data show that SLND in the setting of prior breast implant augmentation through the transaxillary approach is feasible. Additional prospective studies and larger clinical series are necessary to analyze the accuracy of SLND for patients with previous breast implants.
authors.affiliation: Division of Plastic Surgery, University of São Paulo School of Medicine, Rua Oscar Freire 1702 ap 78, Sao Paulo, SP, 05409-011, Brazil. alexandremuhoz@hotmail.com
authors.forename: Alexandre Mendonça
authors.initials: AM
authors.lastname: Munhoz
authors.forename: Cláudia
authors.initials: C
authors.lastname: Aldrighi
authors.forename: Carlos
authors.initials: C
authors.lastname: Buschpiegel
authors.forename: Carla
authors.initials: C
authors.lastname: Ono
authors.forename: Eduardo
authors.initials: E
authors.lastname: Montag
authors.forename: Klaus
authors.initials: K
authors.lastname: Fells
authors.forename: Eduardo
authors.initials: E
authors.lastname: Arruda
authors.forename: Gustavo
authors.initials: G
authors.lastname: Sturtz
authors.forename: Patrick
authors.initials: P
authors.lastname: Kovac
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Filassi
authors.forename: Rolf
authors.initials: R
authors.lastname: Gemperli
authors.forename: Marcus Castro
authors.initials: MC
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D019928:Breast Implantation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D061305:Lymphoscintigraphy; D021701:Sentinel Lymph Node Biopsy / Q000379:methods