Feasibility of sentinel lymph node biopsy through an inframammary incision for a nipple-sparing mastectomy.
BACKGROUND
Nipple-sparing mastectomy (NSM) via an inframammary (IM) incision has been described for selected patients with breast cancer. However, the application of sentinel lymph node (SLN) mapping via an IM incision for NSM has yet to be reported. The objective of this study is to determine the technical feasibility of performing SLN through an IM incision without making an axillary counterincision.


METHODS
We retrospectively reviewed our single-institutional experience with SLN biopsy and NSM through IM incisions between January 2006 and March 2008. Clinicopathologic factors were analyzed regarding indications, technical details, postoperative morbidity, and follow-up.


RESULTS
Fifty-two patients underwent 87 NSM through an IM incision (17 unilateral, 35 bilateral) with immediate reconstruction and SLN biopsy. Indications for surgery included invasive breast cancer (n = 21), ductal carcinoma in situ (DCIS) (n = 18), and prophylactic (n = 48). Mean tumor size of invasive carcinoma was 2.1 cm. The mean mastectomy specimen weight was 437 g. Subareolar injection consisted of blue dye (n = 43), technetium sulfur colloid (n = 2), or combination injection (n = 42). SLN biopsy through an IM incision was successfully performed in 84 of 87 cases (96.6%). A mean of 2.8 SLN were removed with a positive sentinel node encountered in 8 of 21 patients (38%) with invasive cancer. No complications were observed regarding the SLN portion of the operation. With a median follow-up of 6.5 months (range, 0.4-23 months), there have been no axillary local recurrences.


CONCLUSIONS
SLN biopsy can be performed through an IM incision during a NSM, avoiding a secondary axillary incision.
Kiluk
John V
JV
Breast Program, H Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA. john.kiluk@moffitt.org
Santillan
Alfredo A
AA
Kaur
Paramjeet
P
Laronga
Christine
C
Meade
Tammi
T
Ramos
Dan
D
Cox
Charles E
CE
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000601:surgery; D004396:Coloring Agents; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009017:Morbidity; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009558:Nipples / Q000473:pathology / Q000601:surgery*; D011182:Postoperative Care; D012189:Retrospective Studies; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome
D004396:Coloring Agents; D012394:Rosaniline Dyes; C025484:iso-sulfan blue