Feasibility of Performing Sentinel Lymph Node Biopsy (SLNB) after Mastectomy: A Case Report
- 1 Aultman Cancer Center, Canton, OH and Akron General Medical Center, Akron, USA
- 2 Aultman Cancer Center, Canton, OH and Northeastern Ohio Universities College of Medicine, Rootstown, USA
Abstract
Introduction: Previous mastectomy remains a contraindication to SLNB as normal drainage patterns of the breast can be disturbed. Patients diagnosed with DCIS on core biopsy and later found to have microinvasive or invasive carci-noma at the time of mastectomy are deprived of the opportunity for SLNB and need to undergo axillary dissection. We explored the option and feasibility of performing SLNB in a 39-year-old female who underwent a simple mastectomy without axillary sampling for extensive DCIS and later found to have microinvasive ductal carcinoma on permanent pathology. Results: Lymphatic mapping using subdermal injection of 99mTc-labeled sulfur colloid and blue dye led to the identification of five SLNs. Histopathologic examination showed no metastasis. Conclusion: SNLB is feasible in this setting. However, before its use is routinely adopted, its feasibility and accuracy has to be demonstrated in larger num-bers of patients in whom a negative SLNB is followed by a completion axillary dissection.
- D. Dinan, C. E. Nagle, J. Pettinga, “Lymphatic Mapping and Sentinel Node Biopsy in Women with an Ipsilateral Second Breast Carcinoma and a History of Breast and Axillary Surgery,” AJS, Vol. 190, 2005, pp. 614-617.
- A. D. K. Hill, K. N. Tran, T. Akhurst, H. Yeung, S. D. J. Yeh, P. P. Rosen, P. Borgen and H. S. Cody, “Lessons Learned from 500 Cases of Lymphatic Mapping for Breast Cancer,” Annals of Surgery, Vol. 229, No.4, April 1999, pp. 528-535.
- A. E. Giuliano, D. M. Kirgan, J. M. Guenther and D. L. Morton, “Lymphatic Mapping and Sentinel Lymphade-nectomy for Breast Cancer,” Annals of Surgery, Vol. 220, 1994, pp. 391-401.
- A. E. Giuliano, R. C. Jones, M. Brennan and R. Statman, “Sentinel Lymphadenectomy in Breast Cancer,” Journal of Clinical Oncology, Vol. 15, 1997, pp. 2345-2350.
- U. Veronesi, G. Paganelli, V. Galimberti, et al., “Sentinel Node Biopsy to Avoid Axillary Dissection in Breast Cancer with Clinically Negative Nodes,” Lancet, Vol. 349, 1997, pp. 1864-1867.
- A. E. Giuliano, A. M. Barth, B. Spivack, P. D. Beitsch, S. W. Evans, “Incidence and Predictors of Axillary Metas-tases in T1 Carcinoma of the Breast,” Journal of American College Surgeons, Vol. 183, 1996, pp. 185-189.
- D. N. Krag, T. Ashikaga, S. P. Harlow, D. L. Weaver, “Development of Sentinel Node Targeting Techniques in Breast Cancer Patients,” Breast Journal, Vol. 4, 1998, pp. 67-74.
- J. J. Albertini, G. H. Lyman, C. Cox, et al., “Lymphatic Mapping and Sentinel Node Biopsy in the Patient with Breast Cancer,” Journal of the American Medical Associ-ation, Vol. 276, 1996, pp. 1818-1822.
- P. J. Borgstein, S. Meijer, R. Pijpers, “Intradermal Blue Dye to Identify Sentinel Lymph-Node in Breast Cancer,” Lancet, Vol. 349, 1997, pp. 1668-1669.
- J. M. Guenther, M. Krishnamoorthy, L. R. Tan, “Sentinel lymphadenectomy for Breast Cancer in a Community Managed Care Setting,” Cancer Journal, Vol. 3, 1997, pp. 336-340.
- S. Meijer, G. J. Collet, H. J. Pijpers, L. van Hattum, O. S. Hoekstra, “Less Axillary Dissection Necessary Due to Sentinel Node Biopsy in Patients with Breast Carcinoma,” Nederlands Tijdschrift voor Geneeskunde, Vol. 140, 1996, pp. 2239-2243.
- O. E. Nieweg, B. A. Kapteijn, J. L. Peterse, E. J. Rutgers, J. A. van Dongen and B. B. Kroon, “Identification of the Sentinel Node in Patients with Breast Carcinoma,” Ne-derlands Tijdschrift voor Geneeskunde, Vol. 140, 1996, pp. 2235-2239.