Indications for Sentinel Lymph Node Biopsy in the Setting of Prophylactic Mastectomy

Laronga, Christine; Lee, M. Catherine; McGuire, Kandace P.; Meade, Tammi; Carter, W. Bradford; Hoover, Susan; Cox, Charles E.

doi:10.1016/j.jamcollsurg.2009.08.010

Cited by 33 publications

(38 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Laronga et al similarly concluded that routine SLNB is not indicated in patients undergoing bilateral prophylactic mastectomy, and patients with early-stage disease undergoing CPM showed little benefit from biopsy as well [7]. Similar to our findings, Laronga et al found that patients with locally advanced primary cancers ipsilaterally had an increased risk of occult malignancy in the contralateral axilla, perhaps due to crossover metastasis.…”

Section: Discussionsupporting

confidence: 88%

The Role of Sentinel Node Biopsy in Women Undergoing Prophylactic Mastectomy

Nasser

Smith

Chagpar

2010

Journal of Surgical Research

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 88%

The Role of Sentinel Node Biopsy in Women Undergoing Prophylactic Mastectomy

Nasser

Smith

Chagpar

2010

Journal of Surgical Research

View full text Add to dashboard Cite

“…Of these studies, the data of 1 study 16 were updated by McLaughlin and colleagues 17 in 2008, and 1 study 18 was prospective, leaving 6 studies for inclusion in our analysis. The data were extracted from these 6 studies 17,[19][20][21][22][23] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 23 cases of positive SLNs, 12 patients had advanced disease on the contralateral breast ( Table 2). In the study by Laronga and colleagues, 23 57 patients had newly diagnosed locally advanced breast cancer and chose to have a contralateral prophylactic mastectomy. Of these, 8 patients (14%) had contralateral positive SLNs.…”

Section: Features Of Patients With Positive Slnsmentioning

confidence: 99%

Meta-analysis of sentinel lymph node biopsy at the time of prophylactic mastectomy of the breast

Zhou

Dai

et al. 2011

Can J Surg

View full text Add to dashboard Cite

Background: Prophylactic mastectomy is performed to decrease the risk of breast cancer in women at high risk for the disease. The benefit of sentinel lymph node biopsy (SLNB) at the time of prophylactic mastectomy is controversial, and we performed a meta-analysis of the reported data to assess that benefit. Methods:We searched MEDLINE, EMBASE and the Cochrane Library databases from January 1993 to December 2009 for studies on patients who underwent SLNB at the time of prophylactic mastectomy. Two reviewers independently evaluated all the identified papers, and only retrospective studies were included. We used a mixedeffect model to combine data. Results:We included 6 studies in this review, comprising a total study population of 1251 patients who underwent 1343 prophylactic mastectomies. Of these 1343 pooled prophylactic mastectomies, the rate of occult invasive cancer (21 cases) was 1.7% (95% confidence interval [CI] 1.1%-2.5%), and the rate of positive SLNs (23 cases) was 1.9% (95% CI 1.2%-2.6%). In all, 36 cases (2.8%, 95% CI 2.0%-3.8%) led to a significant change in surgical management as a result of SLNB at the time of prophylactic mastectomy. In 17 cases, patients with negative SLNs were found to have invasive cancer at the time of prophylactic mastectomy and avoided axillary lymph node dissection (ALND). In 19 cases, patients with positive SLNBs were found not to have invasive cancer at the time of prophylactic mastectomy and needed a subsequent ALND. Of the 23 cases with positive SLNs, about half the patients had locally advanced disease in the contralateral breast. Conclusion:Sentinel lymph node biopsy is not suitable for all patients undergoing prophylactic mastectomy, but it may be suitable for patients with contralateral, locally advanced breast cancer.Contexte : La mastectomie prophylactique vise à réduire le risque de cancer du sein chez les femmes à risque élevé. L'avantage de la biopsie du ganglion lymphatique sentinelle (BGLS) au moment de la mastectomie prophylactique suscite la controverse et nous avons procédé à une méta-analyse des données qui ont fait l'objet de rapports afin d'évaluer l'avantage en question. Méthodes :Nous avons cherché dans les bases de données MEDLINE, EMBASE et la Bibliothèque Cochrane, de janvier 1993 à décembre 2009, des études portant sur des patientes qui ont subi une BGLS au moment de la mastectomie prophylactique. Deux examinateurs ont évalué indépendamment toutes les études repérées et nous avons inclus seulement les études rétrospectives. Nous avons utilisé un modèle à effets mixtes pour combiner les données.Résultats : Nous avons inclus dans cette analyse 6 études regroupant une population totale de 1251 patientes qui ont subi 1343 mastectomies prophylactiques. Parmi ces 1343 mastectomies prophylactiques regroupées, le taux de cancer envahissant occulte (21 cas) s'est établi à 1,7 % (intervalle de confiance [IC] à 95 %, 1,1 %-2,5 %) et le taux de GLS positifs (23 cas) a atteint 1,9 % (IC à 95 %, 1,2 %-2,6 %). Au total, les constatations dans 36 cas (2,8 %, IC ...

show abstract

“…All three patients underwent a completion ALND and no additional positive lymph nodes were found. Ultimately, all the patients were upstaged to stage II breast cancer Laronga et al (25) 8 Seven (7 of 420; 1.7%) additional patients had a positive contralateral sentinel lymph node without any evidence of occult disease in the prophylactic breast specimen. These seven patients all had locally advanced disease on the established primary breast cancer side, suggesting that all of these cases represent cross-over metastases to the opposite axilla.…”

Section: Efficacy Of Slnb During Pmmentioning

confidence: 99%

“…The third patient had a single tumor cluster containing only a few cells found on IHC stain and remained disease-free after 5 years of follow-up despite no additional therapy. Laronga et al (25) reported eight of their patients with positive prophylactic SLN had locally advanced breast cancers on the index side with ipsilateral nodal involvement, and the metastases in the prophylactic SLN came from the index side breast carcinoma. Memorial Sloan-Kettering Cancer Center (26) discovered one patient with IHC in SLN which was a cross-metastasis from a contralateral T2N3 poorly differentiated breast cancer.…”

Section: Efficacy Of Slnb During Pmmentioning

confidence: 99%

Is Sentinel Lymph Node Biopsy Necessary in Patients Undergoing Prophylactic Mastectomy? A Systematic Review and Meta‐Analysis

Nagaraja¹,

Edirimanne²,

Eslick³

2016

Breast J

View full text Add to dashboard Cite

The gain by performing sentinel lymph node biopsy (SLNB) during prophylactic mastectomy (PM) is debatable, and we performed a meta-analysis of existing literature to evaluate that the role of SLNB in subjects undergoing PM. A systematic search was conducted using MEDLINE, PubMed, EMBASE, Current Contents Connect, Cochrane library, Google Scholar, Science Direct, and Web of Science. The search identified 11 relevant articles reporting on patients who underwent SLNB at the time of PM. Data were abstracted from each study and used to calculate a pooled odds ratio (OR) and 95% confidence interval (95% CI). We included 14 studies comprising of 2,708 prophylactic mastectomies. Among 2,708 prophylactic mastectomies, the frequency of occult invasive cancer (51 cases) was 1.8% and the rate of positive SLNs (33 cases) was 1.2%. In 25 invasive cancers at the time of PM were found to have negative SLNs which avoided axillary lymph node dissection (ALND). In seven cases with positive SLNBs were found not to have invasive cancer at the time of PM and needed a subsequent ALND. Most of the patients with positive SLNs had locally advanced disease in the contralateral breast. SLNB may be suitable for patients with ipsilateral, locally advanced breast cancer and is not recommend for all patients undergoing PM.

show abstract

Indications for Sentinel Lymph Node Biopsy in the Setting of Prophylactic Mastectomy

Cited by 33 publications

References 23 publications

The Role of Sentinel Node Biopsy in Women Undergoing Prophylactic Mastectomy

The Role of Sentinel Node Biopsy in Women Undergoing Prophylactic Mastectomy

Meta-analysis of sentinel lymph node biopsy at the time of prophylactic mastectomy of the breast

Is Sentinel Lymph Node Biopsy Necessary in Patients Undergoing Prophylactic Mastectomy? A Systematic Review and Meta‐Analysis

Contact Info

Product

Resources

About