¿Es posible realizar la biopsia selectiva de ganglio centinela (BSGC) en una paciente con mastectomía preservadora de piel y pezón? Descripción de un caso

BRCA mutation carriers have an increased risk of breast cancer. Among the risk-reducing measures is prophylactic bilateral mastectomy. In less than 1%  of BRCA patients undergoing this surgery, previously undetected breast cancer is found. Routine sentinel lymph node biopsy has not shown benefit because few patients have occult cancer, and it is a technique that also involves morbidity. If a carcinoma is found in the specimen, axillary staging should be done in a second procedure, which has traditionally been performed with lymphadenectomy due to the absence of breast tissue and the belief that sentinel lymph node biopsy (SLNB) is not feasible. We present the case of a patient diagnosed with an infiltrating tumor in the left mastectomy specimen, and successful SLNB performed in a second procedure. Four nodes were sent for intraoperative analysis with negative results. Axillary lymphadenectomy was avoided, achieving proper axillary staging. It is technically feasible to perform SLNB after a skin- and nipple-sparing mastectomy, avoiding systematic axillary lymphadenectomy for staging in these patients, thus avoiding the morbidity associated with this technique.