Annals of Surgical Oncology

, Volume 14, Issue 3, pp 1020–1023

The Role of Sentinel Lymph Node Biopsy in Paget’s Disease of the Breast

  • P. Sukumvanich
  • D. J. Bentrem
  • H. S. Cody III
  • E. Brogi
  • J. V. Fey
  • P. I. Borgen
  • M. L. Gemignani
Article

DOI: 10.1245/s10434-006-9056-2

Cite this article as:
Sukumvanich, P., Bentrem, D.J., III, H.S.C. et al. Ann Surg Oncol (2007) 14: 1020. doi:10.1245/s10434-006-9056-2

ABSTRACT

Background

Sentinel lymph node (SLN) biopsy has become a standard of care for axillary lymph node staging in breast cancer and appears suitable for virtually all patients with clinically node-negative (cN0) invasive disease. However, its role in Paget’s disease of the breast, a condition in which invasion may or may not be present, remains undefined.

Methods

Among 7,083 consecutive SLN biopsy procedures, we retrospectively identified 39 patients with Paget’s disease of the breast. Nineteen patients had no associated clinical/radiographic features (“Paget’s only”), and 20 patients had associated clinical/radiographic findings (“Paget’s with findings”).

Results

The mean ages for the Paget’s alone and with findings groups were 63.6 and 49.6 years, respectively. The use of breast conservation therapy was 32% in the Paget’s alone group and 10% in the Paget’s with findings group. Invasive carcinoma was found in 27% of patients in the Paget’s alone group and 55% of patients in the Paget’s with findings group. The success rate of SLN biopsy was 98%, and the mean number of SLNs removed was 3 in both groups. In the entire cohort of Paget’s disease, 28% (11/39) of the patients had positive SLNs (11%, Paget’s alone; 45%, Paget’s with findings).

Conclusion

In our “Paget’s only” cohort, invasive cancer was found in 27% of cases and positive SLNs in 11%. SLN biopsy should be considered in all patients with Paget’s disease of the breast, whether associated clinical/radiographic findings are present.

Copyright information

© Society of Surgical Oncology 2006

Authors and Affiliations

  • P. Sukumvanich
    • 1
  • D. J. Bentrem
    • 2
  • H. S. Cody III
    • 3
  • E. Brogi
    • 4
  • J. V. Fey
    • 3
  • P. I. Borgen
    • 3
  • M. L. Gemignani
    • 3
  1. 1.Department of Obstetrics, Gynecology and Reproductive SciencesDivision of Gynecologic Oncology, Magee–Womens Hospital, University of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  3. 3.Breast ServiceDepartment of Surgery, Memorial Sloan-Kettering Cancer CenterNew YorkUSA
  4. 4.Department of PathologyMemorial Sloan-Kettering Cancer CenterNew YorkUSA