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International Journal of Breast Cancer
Volume 2018, Article ID 1426369, 7 pages
https://doi.org/10.1155/2018/1426369
Research Article

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

1Department of Gynecology and Obstetrics, Hospital Dr. Nélio Mendonça, Avenida Luís de Camões, No. 57, 9004-514 Funchal, Portugal
2Department of Pathology, Instituto Português de Oncologia Francisco Gentil (IPOLFG), Lisbon, Portugal
3Department of Breast Cancer Risk Evaluation Clinic and Department of Medical Oncology, Instituto Português de Oncologia Francisco Gentil (IPOLFG), Lisbon, Portugal
4Department of Surgical Oncology, Instituto Português de Oncologia Francisco Gentil (IPOLFG), Lisbon, Portugal
5Radiology Department, Instituto Português de Oncologia Francisco Gentil (IPOLFG), Lisbon, Portugal

Correspondence should be addressed to Sara Câmara; moc.liamg@aramac.mac.aras

Received 16 September 2017; Accepted 26 November 2017; Published 1 January 2018

Academic Editor: Vladimir F. Semiglazov

Copyright © 2018 Sara Câmara et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.