Symmetrization reduction mammaplasty combined with sentinel node biopsy in patients operated for contralateral breast cancer.
OBJECTIVE
Occult invasive cancer found in reduction mammaplasty specimen in the contralateral breast in breast cancer patients requires axillary lymph node dissection (ALND) to assess the lymph node status. Routine Sentinel node (SN) biopsy in these patients may avoid secondary ALND when an occult cancer is found and the SN is negative in the permanent histological examination.


METHODS
One hundred sixty-nine breast cancer patients underwent contralateral reduction mammaplasty for symmetrization and with SN biopsy of the non-cancer breast. SN mapping was done using a vital blue dye alone (n = 136) or in combination with a radiocolloid (n = 33).


RESULTS
A mean number of 1.4 SNs (range 1-3 SNs) was identified in 158 of 169 patients (identification rate 93.5%). One of 158 patients revealed a positive SN but no tumor was found in the reduction mammaplasty/mastectomy specimen, whereas the SN was negative in 157 patients. Histological examination of the 169 reduction mammaplasty specimen revealed 5 occult invasive cancers and 4 patients with high grade DCIS but due to a negative SN biopsy the patients were spared a secondary ALND.


CONCLUSIONS
The small number of patients with occult contralateral cancers may not warrant routine SN mapping in patients scheduled for contralateral reduction mammaplasty.
Schrenk
Peter
P
Second Department of Surgery-Ludwig Boltzmann Institute for Surgical Endoscopy, AKH Linz, Linz, Austria. peter.schrenk@liwest.at
Wölfl
Soraya
S
Bogner
Sephan
S
Huemer
Georg M
GM
Huemer
Georg
G
Wayand
Wolfgang
W
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000556:secondary / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy / Q000191:economics