Sentinel Lymph Node Biopsy in the Setting of a Risk Reducing Mastectomy

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Prophylactic Mastectomy / Risk Reducing Mastectomy:
    • Rates are rapidly rising in the United States
  • Prophylactic mastectomy:
    • May be associated with a 3.5% to 5% occurrence of occult carcinoma:
      • Depending on the indication for the operation
  • SLNB at the time of prophylactic mastectomy:
    • May eliminate the need for ALND if occult disease is identified
  • A recent meta-analysis reviewed 14 studies where SLNB was routinely performed for prophylactic mastectomy in patients undergoing bilateral mastectomy for unilateral cancer:
    • This study found metastatic disease in the SLNB of the prophylactic mastectomy:
      • In 0 to 4% of patients with contralateral cancer
    • The majority of metastatic disease was associated with:
      • Contralateral axillary tumor spread from the primary tumor:
        • Not an occult primary tumor
    • In patients who were found to have occult malignancy in the prophylactic mastectomy breast:
      • Less than 1% of sentinel lymph nodes were positive for metastatic disease
  • Given the low rates of occult malignancy and axillary metastasis:
    • SLNB is not indicated for patients undergoing prophylactic mastectomy

#Arrangoiz #BreastSurgeon #BreastExpert #BreastCancer #CancerSurgeon #SurgicalOncologist #MountSinaiMedicalCenter #MSMC #Miami #Mexico #SLNM #SLNB #SentinelLymphNodeBiospy

Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment