Sentinel lymph node biopsy for melanoma in pregnant women.
BACKGROUND
The incidence of melanoma is rising in young women of childbearing age. Melanoma diagnosed during pregnancy presents unique challenges. This study was conducted to determine the effect of sentinel lymph node biopsy (SLNB) for melanoma on maternal and fetal outcomes in pregnant women.


METHODS
A prospective melanoma database was retrospectively queried for women diagnosed with melanoma during or immediately before pregnancy as well as SLNB in pregnant women. The outcomes of SLNB for the mothers and fetuses were evaluated.


RESULTS
Fifteen pregnant women underwent wide local excision (WLE) and SLNB for melanoma from 1997 to 2012. The median gestational age was 20 weeks. More than half of the women noticed changes in the primary melanoma lesion during the pregnancy. The median Breslow thickness was 1.00 mm. Lymphatic mapping and SLNB were performed with some combination of radiocolloid or vital blue dye without adverse effects. Three patients had micrometastatic disease and underwent a completion lymphadenectomy. Sixteen children were born at a median gestational age of 39 weeks. The median 1- and 5-minute Apgar scores were 8 and 9, respectively. At a median follow-up of 54.4, months none of the patients had experienced recurrence, and all children were healthy and free of melanoma.


CONCLUSIONS
In this series of pregnant women with melanoma, SLNB was performed safely during pregnancy without adverse effects to the mothers and fetuses. We recommend that clinicians explain the risks and benefits of the SLNB procedure to pregnant women so an informed decision can be made about the procedure.
Melanoma and Cutaneous Oncology Program, Huntsman Cancer Institute, University of Utah and Intermountain Health Care, Salt Lake City, UT, USA. robert.andtbacka@hci.utah.edu
Robert H I
RH
Andtbacka
Matthew R
MR
Donaldson
Tawnya L
TL
Bowles
Glen M
GM
Bowen
Kenneth
K
Grossmann
Hung
H
Khong
Douglas
D
Grossman
Christopher
C
Anker
Scott R
SR
Florell
Anneli
A
Bowen
Keith L
KL
Duffy
Sancy A
SA
Leachman
R Dirk
RD
Noyes
D000328:Adult; D005260:Female; D005333:Fetus / Q000473:pathology*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000601:surgery*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult