title: Staged sentinel lymph node biopsy before mastectomy facilitates surgical planning for breast cancer patients.
abstract: BACKGROUND
  In patients with breast cancer who choose mastectomy with immediate reconstruction, the sentinel lymph node (SLN) status on permanent histology may complicate treatment if a metastasis is found. The purpose of this study was to determine how performing an SLN biopsy (SLNB) before the definitive operation would influence subsequent surgical procedures.
  
  
  METHODS
  Our SLN database was searched for patients who underwent staged SLNB with subsequent mastectomy between 2001 and 2004.
  
  
  RESULTS
  Twenty-five patients with 27 breast cancers underwent SLNB before mastectomy. Of them, 9 of 27 (33%) were node positive. All 9 patients underwent modified radical mastectomy. Three node-positive patients did not undergo immediate reconstruction. Of the remaining 6 node-positive patients, 5 underwent reconstruction with autologous tissue rather than a tissue expander. In contrast, 6 of 16 (37%) node-negative patients underwent reconstruction with a tissue expander.
  
  
  CONCLUSIONS
  Staged SLNB assists in selecting the appropriate operation in patients who are considering immediate reconstruction.
authors.affiliation: Division of Surgical Oncology, University of North Carolina at Chapel Hill, 3010 Old Clinic Bldg., CB No. 7213, Chapel Hill, NC 27599, USA. nancy_demore@med.unc.edu
authors.forename: Nancy
authors.initials: N
authors.lastname: Klauber-Demore
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Calvo
authors.forename: C Scott
authors.initials: CS
authors.lastname: Hultman
authors.forename: Hong Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Michael O
authors.initials: MO
authors.lastname: Meyers
authors.forename: Lynn
authors.initials: L
authors.lastname: Damitz
authors.forename: Jill S
authors.initials: JS
authors.lastname: Frank
authors.forename: Karen B
authors.initials: KB
authors.lastname: Stitzenberg
authors.forename: Carolyn I
authors.initials: CI
authors.lastname: Sartor
authors.forename: David W
authors.initials: DW
authors.lastname: Ollila
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*