1. Axillary staging for breast cancer during pregnancy: feasibility and safety of sentinel lymph node biopsy.
- Author
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Han SN, Amant F, Cardonick EH, Loibl S, Peccatori FA, Gheysens O, Sangalli CA, Nekljudova V, Steffensen KD, Mhallem Gziri M, Schröder CP, Lok CAR, Verest A, Neven P, Smeets A, Pruneri G, Cremonesi M, and Gentilini O
- Subjects
- Adult, Axilla, Breast Neoplasms diagnosis, Breast Neoplasms mortality, Feasibility Studies, Female, Follow-Up Studies, Germany epidemiology, Humans, Lymphatic Metastasis pathology, Maternal Exposure adverse effects, Middle Aged, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Observational Studies as Topic, Pregnancy, Pregnancy Complications diagnosis, Pregnancy Complications mortality, Pregnancy Outcome, Radioactive Tracers, Registries statistics & numerical data, Retrospective Studies, Sentinel Lymph Node pathology, Sentinel Lymph Node Biopsy methods, Technetium Tc 99m Aggregated Albumin administration & dosage, Technetium Tc 99m Aggregated Albumin adverse effects, Breast Neoplasms pathology, Lymphatic Metastasis diagnosis, Neoplasm Recurrence, Local epidemiology, Pregnancy Complications pathology, Sentinel Lymph Node Biopsy adverse effects
- Abstract
Background: Safety of sentinel lymph node (SLN) biopsy for breast cancer during pregnancy is insufficiently explored. We investigated efficacy and local recurrence rate in a large series of pregnant patients., Patients and Methods: Women diagnosed with breast cancer who underwent SLN biopsy during pregnancy were identified from the International Network on Cancer, Infertility and Pregnancy, the German Breast Group, and the Cancer and Pregnancy Registry. Chart review was performed to record technique and outcome of SLN biopsy, locoregional and distant recurrence, and survival., Results: We identified 145 women with clinically N0 disease who underwent SLN during pregnancy. The SLN detection techniques were as follows:
99m Tc-labeled albumin nanocolloid only (n = 96; 66.2%), blue dye only (n = 14; 9.7%), combined technique (n = 15; 10.3%), or unknown (n = 20; 13.8%). Mapping was unsuccessful in one patient (0.7%) and she underwent an axillary lymph node dissection (ALND). Mean number of SLNs was 3.2 (interquartile range 1-3; missing n = 15). Positive SLNs were found in 43 (29.7%) patients and 34 subsequently underwent ALND. After a median follow-up of 48 months (range 1-177), 123 (84.8%) patients were alive and free of disease. Eleven patients experienced a locoregional relapse, including 1 isolated ipsilateral axillary recurrence (0.7%). Eleven (7.6%) patients developed distant metastases, of whom 9 (6.2%) died of breast cancer. No neonatal adverse events related to SLN procedure during pregnancy were reported., Conclusions: SLN biopsy during pregnancy has a comparably low axillary recurrence rate as in nonpregnant women. Therefore, this method can be considered during pregnancy instead of standard ALND for early-stage, clinically node-negative breast cancer.- Published
- 2018
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