title: Lymphatic mapping could not be impaired in the presence of breast carcinoma and coexisting small lymphocytic lymphoma.
abstract: Female, 66 FINAL DIAGNOSIS: Infiltrating ductal carcinoma • small lymphocytic lymphoma
  
  
  
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  - Clinical Procedure: Sentinel Lymph Node Biopsy • lumpectomy • axillary lymph node dissection Specialty: Breast cancer surgery.
  
  
  
  Rare presentation of two concomitant malingancies.
  
  
  
  Lymphatic mapping of axillary breast cancer metastases in the presence of concomitant lymphoproliferative disease is still a controversial topic. Previous reports have postulated that tumor collision in the lymph nodes could lead to false-negative results of sentinel lymph node biopsy, leading to erroneous staging.
  
  
  
  We present the case of a 66-year-old woman with infiltrating ductal breast carcinoma and small lymphocytic lymphoma in whom we performed a lumpectomy and sentinel lymph node biopsy with Technetium-99 and 1% methylene blue, followed by axillary lymph node dissection regardless of the intraoperative status, which was negative. Final pathology confirmed the absence of lymph node metastases.
  
  
  
  Previously published cases reported correct assessment of SLNB in patients with concomitant small lymphocytic lymphoma and breast carcinoma. We postulate a possible pathological explanation for this: lymphoid cell clusters with pseudofollicles or proliferative centers of small lymphocytic lymphoma are localized outside the nodal sinuses of the lymph node, maintaining its capability of draining, and thus, the feasibility of SLNB in these patients, as in the presented case.
authors: Breast Surgical Unit, Breast Cancer Center, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
authors: Sebastian
authors: S
authors: Arana
authors: Jorge
authors: J
authors: Vasquez-Del-Aguila
authors: Martin
authors: M
authors: Espinosa-Bravo
authors: Vicente
authors: V
authors: Peg
authors: Isabel T
authors: IT
authors: Rubio
keywords: Sentinel Lymph Node Biopsy (SLNB); breast cancer; lymphoid malignancies
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