Annals of Surgical Oncology

, Volume 15, Issue 12, pp 3402–3406

Feasibility of Sentinel Lymph Node Biopsy Through an Inframammary Incision for a Nipple-Sparing Mastectomy

  • John V. Kiluk
  • Alfredo A. Santillan
  • Paramjeet Kaur
  • Christine Laronga
  • Tammi Meade
  • Dan Ramos
  • Charles E. Cox
Breast Oncology

DOI: 10.1245/s10434-008-0156-z

Cite this article as:
Kiluk, J.V., Santillan, A.A., Kaur, P. et al. Ann Surg Oncol (2008) 15: 3402. doi:10.1245/s10434-008-0156-z

Abstract

Background

Nipple-sparing mastectomy (NSM) via an inframammary (IM) incision has been described for selected patients with breast cancer. However, the application of sentinel lymph node (SLN) mapping via an IM incision for NSM has yet to be reported. The objective of this study is to determine the technical feasibility of performing SLN through an IM incision without making an axillary counterincision.

Methods

We retrospectively reviewed our single-institutional experience with SLN biopsy and NSM through IM incisions between January 2006 and March 2008. Clinicopathologic factors were analyzed regarding indications, technical details, postoperative morbidity, and follow-up.

Results

Fifty-two patients underwent 87 NSM through an IM incision (17 unilateral, 35 bilateral) with immediate reconstruction and SLN biopsy. Indications for surgery included invasive breast cancer (n = 21), ductal carcinoma in situ (DCIS) (n = 18), and prophylactic (n = 48). Mean tumor size of invasive carcinoma was 2.1 cm. The mean mastectomy specimen weight was 437 g. Subareolar injection consisted of blue dye (n = 43), technetium sulfur colloid (n = 2), or combination injection (n = 42). SLN biopsy through an IM incision was successfully performed in 84 of 87 cases (96.6%). A mean of 2.8 SLN were removed with a positive sentinel node encountered in 8 of 21 patients (38%) with invasive cancer. No complications were observed regarding the SLN portion of the operation. With a median follow-up of 6.5 months (range, 0.4–23 months), there have been no axillary local recurrences.

Conclusion

SLN biopsy can be performed through an IM incision during a NSM, avoiding a secondary axillary incision.

Abbreviations

IM

inframammary incision

NAC

nipple areolar complex

NSM

nipple-sparing mastectomy

SLN

sentinel lymph node

Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • John V. Kiluk
    • 1
    • 2
  • Alfredo A. Santillan
    • 1
    • 2
  • Paramjeet Kaur
    • 1
    • 2
  • Christine Laronga
    • 1
    • 2
  • Tammi Meade
    • 1
    • 2
  • Dan Ramos
    • 1
    • 2
  • Charles E. Cox
    • 1
    • 2
  1. 1.MCC—Breast ProgramH. Lee Moffitt Cancer Center & Research Institute (MCC)TampaUSA
  2. 2.Department of SurgeryUniversity of South Florida College of MedicineTampaUSA