the use of sentinel lymph node biopsy in brca1/2 mutation carriers undergoing prophylactic mastectomy: a retrospective consecutive case-series study
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2018
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Abstract
Introduction. Sentinel lymph node biopsy in prophylactic mastectomy is controversial. It avoids lymphadenectomy in occult carcinoma but is associated with increased morbidity. Women with BRCA mutations have a higher incidence of occult carcinoma and our objective was to assess the clinical utility of sentinel lymph node biopsy when these women undergo prophylactic mastectomy. Materials and Methods. Seven-year retrospective consecutive case-series study of women, with a BRCA deleterious mutation, admitted to prophylactic mastectomy, at our center. Breast MRI < 6 months before surgery was routine, unless contraindicated. Results. Fifty-seven patients (43% BRCA1; 57% BRCA2) underwent 80 prophylactic mastectomies. 72% of patients had had breast cancer treated before prophylactic mastectomy or synchronously to it. The occult carcinoma incidence was 5%, and half of the cases were invasive. SLNB was performed in 19% of the prophylactic mastectomies; none of these had tumor invasion. Women with invasive carcinoma who had not undergone sentinel lymph node biopsy were followed closely with axillary ultrasound. The median follow-up was 37 months, with no local recurrence; 1 patient died of primary tumor systemic relapse. Conclusions. Our data do not support this procedure for routine (in agreement with previous literature), in this high risk for occult carcinoma population.
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| Authors | ;Sara Câmara;Daniela Pereira;Saudade André;Beatriz Mira;Fátima Vaz;Rodrigo Oom;José Carlos Marques;João Leal de Faria;Catarina Rodrigues dos Santos |
| Journal | BMC public health |
| Year | 2018 |
| DOI |
10.1155/2018/1426369
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