Sentinel lymph node biopsy in pregnant patients with breast cancer

  • Oreste Gentilini
  • Marta Cremonesi
  • Antonio Toesca
  • Nicola Colombo
  • Fedro Peccatori
  • Roberto Sironi
  • Claudia Sangalli
  • Nicole Rotmensz
  • Guido Pedroli
  • Giuseppe Viale
  • Paolo Veronesi
  • Viviana Galimberti
  • Aron Goldhirsch
  • Umberto Veronesi
  • Giovanni Paganelli
Original Article

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 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Oreste Gentilini
    • 1
  • Marta Cremonesi
    • 2
  • Antonio Toesca
    • 1
  • Nicola Colombo
    • 3
  • Fedro Peccatori
    • 4
  • Roberto Sironi
    • 5
  • Claudia Sangalli
    • 1
  • Nicole Rotmensz
    • 6
  • Guido Pedroli
    • 2
  • Giuseppe Viale
    • 7
    • 8
  • Paolo Veronesi
    • 1
  • Viviana Galimberti
    • 1
  • Aron Goldhirsch
    • 9
  • Umberto Veronesi
    • 1
    • 10
  • Giovanni Paganelli
    • 11
  1. 1.Division of SenologyEuropean Institute of OncologyMilanItaly
  2. 2.Unit of Medical PhysicsEuropean Institute of OncologyMilanItaly
  3. 3.Unit of CardiologyEuropean Institute of OncologyMilanItaly
  4. 4.Division of Haematology-OncologyEuropean Institute of OncologyMilanItaly
  5. 5.Unit of Obstetrics and GynecologyS. Pio X HospitalMilanItaly
  6. 6.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyMilanItaly
  7. 7.Division of PathologyEuropean Institute of OncologyMilanItaly
  8. 8.University of Milan School of MedicineMilanItaly
  9. 9.Department of MedicineEuropean Institute of OncologyMilanItaly
  10. 10.European Institute of OncologyMilanItaly
  11. 11.Division of Nuclear MedicineEuropean Institute of OncologyMilanoItaly

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