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Sentinel lymph node biopsy is feasible even after total mastectomy
Author(s) -
Intra Mattia,
Veronesi Paolo,
Gentilini Oreste D.,
Trifirò Giuseppe,
Berrettini Anastasio,
Cecilio Rafaela,
Colleoni Marco,
Rietjens Mario,
Luini Alberto,
Paganelli Giovanni,
Veronesi Umberto
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20670
Subject(s) - medicine , sentinel lymph node , contraindication , surgery , biopsy , mastectomy , axilla , breast cancer , total mastectomy , sentinel node , axillary lymph node dissection , breast reconstruction , radiology , cancer , pathology , alternative medicine
Background Previous mastectomy is unanimously considered to represent an absolute technical contraindication to sentinel lymph node biopsy (SLNB). Methods Four patients who underwent total mastectomy and plastic reconstruction with prosthesis, developed, during the follow up, a unique invasive limited local subdermic recurrence amenable to surgical excision, with clinically negative axillary nodes. In all patients preoperative lymphoscintigraphy with subdermal injection of 99m Tc‐labeled colloidal particles correctly showed an axillary sentinel lymph node (SLN). Results Metastases in SLN were detected in two patients, and a complete axillary dissection followed. The remaining two patients had a negative SLN and no axillary clearance was performed. Conclusions In selected cases, the subdermal injection of radioisotope permits the identification of an axillary SLN, even in mastectomized patients. Despite SLNB in mastectomized patients being technically feasible, only a larger population and longer patient follow up could confirm its true predictive value. However, there are no anatomical or physiological reasons to exclude “a priori” this diagnostic opportunity. J. Surg. Oncol. 2007;95:175–179. © 2007 Wiley‐Liss, Inc.