Safety of sentinel node biopsy in pregnant patients with breast cancer

Gentilini, Oreste; Cremonesi, Marta; Trifirò, Giuseppe; Ferrari, Mahila; Baio, Silvia M.; Caracciolo, M.; Rossi, Annalisa; Smeets, Ann; Galimberti, Viviana; Luini, Alberto; Tosi, G; Paganelli, Giovanni

doi:10.1093/annonc/mdh355

Cited by 200 publications

(99 citation statements)

References 11 publications

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“…Using two nonpregnant patient exposures, Keleher and colleagues [52] in 2004 estimated the maximum absorbed dose to the fetus/embryo in pregnant women undergoing breast lymphoscintigraphy with 92.5MBq (2.5mCi) of 99m Tc-Sulfur Colloid as 4.3 mGy using the Medical Internal Radiation Dosimetry (MIRD) program. The same year, Gentilini and colleagues [53] measured activity using thermoluminescent dosimeters combined with static and whole-body scintigraphic imaging in 26 nonpregnant patients exposed to lymphoscintigraphy and overestimated the fetal absorbed dose as 61 mGy. In 2006, Pandit-Taskar and colleagues [54] retrospectively assessed the absorbed doses to various organs and a modeled fetus using standard internal absorbed dose assessment methodologies and phantom models in 1021 nonpregnant women undergoing sentinel node mapping and biopsy and estimated the absorbed fetal dose as 14 mGy.…”

Section: Management Of the Axillamentioning

confidence: 99%

Pregnancy-Associated Breast Cancer: A Literature Review

Barnes

Newman

2007

Surgical Clinics of North America

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Breast cancer, along with cervical cancer, is one of the most commonly diagnosed cancers of pregnancy. Most would define gestational breast cancer as breast cancer that is diagnosed during pregnancy, lactation, and up to 12 months post-partum. The diagnostic and therapeutic implications in this clinical setting are special. These women typically present with a more advanced-stage disease that carries an associated poorer prognosis. Physicians thus are challenged to balance aggressive maternal care with appropriate modifications that will ensure fetal protection. . Of women diagnosed with breast cancer younger than 40 years, only approximately 10% will be pregnant [2,3]. These data certainly suggest a low incidence of pregnancy-associated breast cancer. In fact, historically, the incidence is estimated at 1 in 3000 pregnancies [4][5][6]. Despite the overall low incidence, however, gestational breast cancer is one of the most common pregnancy-associated malignancies, second only to cervical cancer [4,6]. Notably, many have offered that this incidence will only increase as more women delay childbearing until later in life [4,7]. This concern is based on the fact that pregnancy-associated breast cancer is age-related, and women

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Section: Management Of the Axillamentioning

confidence: 99%

Pregnancy-Associated Breast Cancer: A Literature Review

Barnes

Newman

2007

Surgical Clinics of North America

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“…The surgical approach may be wide local excision along with exploration or dissection of local nodal groups. Sentinel lymph node biopsy was recently proposed to localize, recognize and remove metastatic axillary lymph nodes from ectopic breast cancer [7,8]. Whether ipsilateral breast irradiation offers an advantage is not exactly known.…”

Section: Discussionmentioning

confidence: 99%

Hypermetabolic Axillary Mass on 18F FDG PET/CT: Breast Cancer Arising from Accessory Breast Tissue

Park

Lee

Bae

et al. 2010

Nucl Med Mol Imaging

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Differential diagnosis among several causes of axillary malignant mass is important. The most common cause of palpable malignant axillary mass is metastatic lymphadenopathy. Although carcinoma arising from ectopic breast tissue is rare, the diagnosis should be kept in mind when evaluating malignant axillary mass. In this report we present a case with carcinoma arising from ectopic breast tissue. 18 F FDG PET/CT was performed for the purpose of localizing primary breast cancer lesion and systemic evaluation. PET/CT showed hypermetabolic lesions only in the right axilla. There is no evidence of malignancy in both breasts. When nuclear physicians encounter a hypermetabolic axillary mass indicating malignant lesion without evidence of primary breast malignant lesion, carcinoma arising from ectopic breast tissue should be included in the differential diagnosis.

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“…The results of at least five studies examined safety of the procedure for fetus in pregnant patients affected with melanoma or breast cancer. Gentilini et al (Gentilini et al, 2004) have indirectly estimated the possible fetus exposure after application of radiopharmaceutical and its distribution in 26 premenopausal nonpregnant patients. They concluded that fetus exposure would be minimal and therefore the procedure could be safe for application in pregnant patients.…”

Section: Sentinel Nodementioning

confidence: 99%