Original Article

European Journal of Nuclear Medicine and Molecular Imaging

, Volume 37, Issue 1, pp 78-83

First online:

Sentinel lymph node biopsy in pregnant patients with breast cancer

  • Oreste GentiliniAffiliated withDivision of Senology, European Institute of Oncology
  • , Marta CremonesiAffiliated withUnit of Medical Physics, European Institute of Oncology
  • , Antonio ToescaAffiliated withDivision of Senology, European Institute of Oncology
  • , Nicola ColomboAffiliated withUnit of Cardiology, European Institute of Oncology
  • , Fedro PeccatoriAffiliated withDivision of Haematology-Oncology, European Institute of Oncology
  • , Roberto SironiAffiliated withUnit of Obstetrics and Gynecology, S. Pio X Hospital
  • , Claudia SangalliAffiliated withDivision of Senology, European Institute of Oncology
  • , Nicole RotmenszAffiliated withDivision of Epidemiology and Biostatistics, European Institute of Oncology
  • , Guido PedroliAffiliated withUnit of Medical Physics, European Institute of Oncology
    • , Giuseppe VialeAffiliated withDivision of Pathology, European Institute of OncologyUniversity of Milan School of Medicine
    • , Paolo VeronesiAffiliated withDivision of Senology, European Institute of Oncology
    • , Viviana GalimbertiAffiliated withDivision of Senology, European Institute of Oncology
    • , Aron GoldhirschAffiliated withDepartment of Medicine, European Institute of Oncology
    • , Umberto VeronesiAffiliated withDivision of Senology, European Institute of OncologyEuropean Institute of Oncology
    • , Giovanni PaganelliAffiliated withDivision of Nuclear Medicine, European Institute of Oncology Email author 

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Abstract

Purpose

Sentinel lymph node biopsy (SLNB) is currently not recommended in pregnant patients with breast cancer due to radiation concerns.

Methods

Twelve pregnant patients with breast cancer received low-dose (10 MBq on average) lymphoscintigraphy using 99mTc human serum albumin nanocolloids.

Results

The sentinel lymph node (SLN) was identified in all patients. Of the 12 patients, 10 had pathologically negative SLN. One patient had micrometastasis in one of four SLN. One patient had metastasis in the SLN and underwent axillary clearance. From the 12 pregnancies, 11 healthy babies were born with no malformations and normal weight. One baby, whose mother underwent lymphatic mapping during the 26th week of gestation, was operated on at the age of 3 months for a ventricular septal defect and at 43 months was in good health. This malformation was suspected at the morphological US examination during week 21, well before lymphoscintigraphy, and was confirmed a posteriori by a different observer based on videotaped material. No overt axillary recurrence appeared in the patients with negative SLNs after a median follow-up of 32 months.

Conclusion

Our experience supports the safety of SLNB in pregnant patients with breast cancer, when performed with a low-dose lymphoscintigraphic technique.

Keywords

Sentinel node Breast cancer Pregnancy Lymphoscintigraphy