The role of sentinel lymph node biopsy in Paget's disease of the breast.

Autor: Sukumvanich P; Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Bentrem DJ, Cody HS 3rd, Brogi E, Fey JV, Borgen PI, Gemignani ML
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2007 Mar; Vol. 14 (3), pp. 1020-3.
DOI: 10.1245/s10434-006-9056-2
Abstrakt: 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.
Databáze: MEDLINE
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