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Dermal invasion matters in breast cancer sentinel lymph node biopsy results

  • Montserrat Solà1,*,
  • Mireia Recaj2
  • Eva Castellà3
  • Antonio Urban4
  • Laura Hernández3
  • Juan Francisco Julian5
  • Gloria Moragas1

1Department of Nuclear Medicine, Hospital Universitari Germans Trias i Pujol de Badalona, 08916 Badalona, Spain

2Department of Surgery, General Hospital Sant Jaume de Calella, 08370 Calella, Spain

3Department of Pathology, Hospital Universitari Germans Trias i Pujol de Badalona, 08916 Badalona, Spain

4Department of Pathology, Hospital Sant Jaume de Calella, 08370 Calella, Spain

5Department of Surgery, Hospital Universitari Germans Trias i Pujol de Badalona, 08916 Badalona, Spain

DOI: 10.22514/ejgo.2022.029 Vol.43,Issue 4,August 2022 pp.101-105

Submitted: 03 June 2022 Accepted: 13 July 2022

Published: 15 August 2022

*Corresponding Author(s): Montserrat Solà E-mail: msola.germanstrias@gencat.cat

Abstract

The aim of this study was to evaluate whether cancer invasion of the dermis could hamper drainage of the radiotracer in breast cancer patients who were undergoing a Sentinel Lymph Node Biopsy (SLNB) procedure. Ten patients who presented with T1-T2 breast cancer with dermal invasion alone as confirmed by a punch biopsy of skin were evaluated. For the SLNB procedure, a lymphoscintigraphy was performed 2 hours after intratumoral administration of 2 mCi (74 MBq) of 99mTc nanocolloid. The sentinel lymph nodes (SLN) were evaluated for the presence of tumor cells by hematoxylin-eosin staining and, when negative, by immunocytochemistry using anti-cytokeratin antibody (CAM 5.2). No migration of radiotracer was found in three patients, and one patient had a false negative SLN, so altogether the technique failed in four patients (40%). Axillary nodes proved to be positive in seven patients (70%).The high rate of failure in the lymphatic mapping and the high proportion of axillary positivity suggest a causal relationship with the invasion of the dermis, with possible implications for the validity of the SLNB procedure.


Keywords

Sentinel node; Breast; Dermal invasion


Cite and Share

Montserrat Solà,Mireia Recaj,Eva Castellà,Antonio Urban,Laura Hernández,Juan Francisco Julian,Gloria Moragas. Dermal invasion matters in breast cancer sentinel lymph node biopsy results. European Journal of Gynaecological Oncology. 2022. 43(4);101-105.

References

[1] Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging manual. 7th edn. Springer: New York. 2010.

[2] Güth U, Singer G, Langer I, Schötzau A, Herberich L, Holzgreve W, Wight E. T4 category revision enhances the accuracy and significance of stage III breast cancer. Cancer. 2006; 106: 2569–2575.

[3] Lyman GH, Somerfield MR, Bosserman LD, Perkins CL, Weaver DL, Giuliano AE. Sentinel lymph node biopsy for patients with early-stage breast cancer: American society of clinical oncology clinical practice guideline update. Journal of Clinical Oncology. 2017; 35: 561–564.

[4] Fraile M, Rull M, Julian FJ, Fuste F, Barnadas A, Llatjos M, et al. Sentinel node biopsy as a practical alternative to axillary lymph node dissection in breast cancer patients: an approach to its validity. Annals of Oncology. 2000; 11: 701–705.


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