The Use of Sentinel Lymph Node Biopsy in BRCA1/2 Mutation Carriers Undergoing Prophylactic Mastectomy: A Retrospective Consecutive Case-Series Study.

IF 1.6 Q4 ONCOLOGY
Sara Câmara, Daniela Pereira, Saudade André, Beatriz Mira, Fátima Vaz, Rodrigo Oom, José Carlos Marques, João Leal de Faria, Catarina Rodrigues Dos Santos
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引用次数: 0

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.

Abstract Image

在接受预防性乳房切除术的 BRCA1/2 基因突变携带者中使用前哨淋巴结活检:回顾性连续病例系列研究。
前言:预防性乳房切除术中的前哨淋巴结活检存在争议。前哨淋巴结活检可避免对隐匿性癌进行淋巴结切除,但会增加发病率。BRCA 基因突变的女性隐匿性癌的发病率较高,我们的目的是评估这些女性接受预防性乳房切除术时前哨淋巴结活检的临床实用性:本中心对接受预防性乳房切除术的 BRCA 基因致畸突变妇女进行了为期 7 年的回顾性连续病例系列研究。除非有禁忌症,否则术前<6个月进行乳腺核磁共振检查是常规做法:57名患者(43%为BRCA1;57%为BRCA2)接受了80例预防性乳房切除术。72%的患者在接受预防性乳房切除术之前或同步接受过乳腺癌治疗。隐匿性癌的发生率为 5%,半数病例为浸润性癌。19%的预防性乳房切除术中进行了SLNB,其中没有肿瘤侵犯。对未进行前哨淋巴结活检的浸润性癌妇女进行了腋窝超声密切随访。中位随访时间为 37 个月,无局部复发;1 名患者死于原发肿瘤全身复发:我们的数据不支持在这一隐匿性癌症高危人群中将该手术作为常规手术(与之前的文献一致)。
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来源期刊
CiteScore
3.40
自引率
0.00%
发文量
25
审稿时长
19 weeks
期刊介绍: International Journal of Breast Cancer is a peer-reviewed, Open Access journal that provides a forum for scientists, clinicians, and health care professionals working in breast cancer research and management. The journal publishes original research articles, review articles, and clinical studies related to molecular pathology, genomics, genetic predisposition, screening and diagnosis, disease markers, drug sensitivity and resistance, as well as novel therapies, with a specific focus on molecular targeted agents and immune therapies.
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