Sentinel lymph node biopsy in breast cancer patients undergoing skin/nipple-sparing mastectomy and immediate autologous reconstruction

Tanaka,Satoru; Nohara,Takehiro; Iwamoto,Mitsuhiko; Sumiyoshi,Kazuhiro; Kimura,Kosei; Takahashi,Yuko; Tanigawa,Nobuhiko

doi:10.3892/ol_00000018

Sentinel lymph node biopsy in breast cancer patients undergoing skin/nipple-sparing mastectomy and immediate autologous reconstruction

Authors:
- Satoru Tanaka
- Takehiro Nohara
- Mitsuhiko Iwamoto
- Kazuhiro Sumiyoshi
- Kosei Kimura
- Yuko Takahashi
- Nobuhiko Tanigawa
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Affiliations: Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka 569-8686, Japan
Published online on: January 1, 2010 https://doi.org/10.3892/ol_00000018
Pages: 99-101

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Abstract

Immediate breast reconstruction following mastectomy is an effective treatment for breast cancer patients. Among several implant options, a latissimus dorsi myocutaneous (LDM) flap is used mainly due to the ease and minimal invasiveness of the procedure. The role of sentinel lymph node (SLN) biopsy with total mastectomy is evolving. Since SLN biopsy is not included in health insurance coverage in the treatment of patients in Japan, it is not generally performed as a separate procedure due to its cost. The present study reviewed the results of seven patients who underwent initial-staged SLN biopsy followed by planned mastectomy and LDM flap reconstruction. Two patients with positive SLNs showed macrometastases and underwent modified radical mastectomy with immediate reconstruction. In contrast, cases showing negative results for sentinel lymph nodes underwent total mastectomy. There were no false-negative cases among the SLN biopsy-negative cases. When an SLN is found to be positive on final pathology, the patient with reconstruction by LDM flap generally requires a potentially difficult reoperation on the remaining axillary nodes. When initial SLN biopsy is generally performed as a separate procedure in Japan, it will be an effective method for screening the axilla for patients who wish to undergo LDM flap reconstruction.

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