Sentinel node biopsy in male breast carcinoma: is the “female” approach justified?

Purpose: Mastectomy with axillary lymph node dissection (ALND) represents the gold standard in the treatment of male breast carcinoma. Recently, data have emerged supporting that sentinel lymph node biopsy (SNB) may be feasible in selected patients. The aim of this study was to analyze the safety and prognostic reliability of SNB in male patients with breast carcinoma and clinically negative axilla. Methods: During a 10-year period (2000-2010), 11 men with mean age 66.1 years (range 34-84) diagnosed with breast carcinoma were retrospectively included to our study. All patients underwent SNB. Regardless of the SNB results, completion axillary clearance was conducted in all cases. Results: SNB detection rate was 100%, while the mean number of sentinel nodes removed was 1.5 +/- 0.7 (range 1-2). Frozen section analysis revealed a negative sentinel node in four out of 11 patients (36.4%). Independently of these results, all patients underwent completion ALND. The overall false-negative rate, defined as the percentage of all node-positive tumors in which the SNB was negative, was 0%. Conclusion: The current study indicates that SNB may be feasible in selected male individuals with breast carcinoma. The technique may reduce the morbidity related to dissection of the axilla; prospective multicenter trials are needed in order to define the exact criteria for wider application of this technique.

Male breast cancer; Sentinel node; Prognostic reliability

[1] Fentiman I.S., Fourquet A., Hortobagyi G.N.: “Male breast cancer”. Lancet, 2006, 367, 595.

[2] Borgen P.I., Senie R.T., McKinnon W.M., Rosen P.P.: “Carcinoma of the male breast: analysis of prognosis compared with matched female patients”. Ann. Surg. Oncol., 1997, 4, 385.

[3] Vetto J., Jun S.Y., Paduch D., Eppich H., Shih R., Padduch D.: “Stages at presentation, prognostic factors, and outcome of breast cancer in males”. Am. J. Surg., 1999, 177, 379.

[4] De Cicco C., Baio S.M., Veronesi P., Trifiro G., Ciprian A., Vento A. et al.: “Sentinel node biopsy in male breast cancer”. Nucl. Med. Commun., 2004, 25, 139.

[5] Cutuli B., Le-Nir C.C., Serin D., Kirova Y., Gaci Z., Lemanski C. et al.: “Male breast cancer. Evolution of treatment and prognostic factors. Analysis of 489 cases”. Crit. Rev. Oncol. Hematol., 2010, 73, 246.

[6] Goyal A., Horgan K., Kissin M., Yiangou C., Sibbering M., Lansdown M. et al.: “Sentinel lymph node biopsy in male breast cancer patients”. Eur. J. Surg. Oncol., 2004, 30, 480.

[7] Boughey J.C., Bedrosian I., Meric-Bernstam F., Ross M.I., Kuerer H.M., Akins J.S. et al.: “Comparative analysis of sentinel lymph node operation in male and female breast cancer patients”. J. Am. Coll. Surg., 2006, 203, 475.

[8] Levi F., Lucchini F., La Vecchia C.: “Epidemiology of male breast cancer”. Eur. J. Cancer Prev., 2002, 11, 315.

[9] Flynn L.W., Park J., Patil S.M., Cody H.S., Port E.R.: “Sentinel lymph node biopsy is successful and accurate in male breast carcinoma”. J. Am. Coll. Surg., 2008, 206, 616.

[10] Gentilini O., Chagas E., Zurrida S., Intra M., De Cicco C., Gatti G. et al.: “Sentinel lymph node biopsy in male patients with early breast cancer”. Oncologist, 2007, 12, 512.

[11] Port E.R., Fey J.V., Cody H.S., Borgen P.I.: “Sentinel lymph node biopsy in patients with male breast carcinoma”. Cancer, 2001, 91, 319.

[12] Burga A.M., Fadare O., Lininger R.A., Tavassoli F.A.: “Invasive carcinomas of the male breast: a morphologic study of the distribution of histologic subtypes and metastatic patterns in 778 cases”. Virchows Arch., 2006, 449, 507.

[13] Foschini M.P., Krausz T.: “Salivary gland-type tumors of the breast: a spectrum of benign and malignant tumors including triple negative carcinomas of low malignant potential”. Semin. Diagn. Pathol., 2010, 27, 77.