Lymphatic mapping for male breast cancer

Daniel Albo, F. C. Ames, K. K. Hunt, M. I. Ross, S. E. Singletary, H. M. Kuerer

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Sentinel lymph node biopsy (SLNB) is emerging as an alternative to axillary lymph node dissection (ALND) for many female breast cancer patients. In contrast, ALND remains the standard of care tor male breast patients with similar tumors. We evaluated the results of SLNB in male breast cancer patients with clinically negative axillas. METHODS: The patient population consisted of six consecutive male breast cancer patients, ages 44 to 76 years old, treated at our institution. All patients had negative axillas by clinical exam and ultrasound. Preoperative lymphoscintigraphy was used in all cases. In each patient, 5 cc of isosulfan blue 1% was injected intraoperatively adjacent to the breast tumor or biopsy cavity prior to SLNB. Additionally, Tc-99m sulfur colloid was injected at a dose of 0.5 mCi 4 hours before surgery (2 patients) or 2.5 mCi 24 hours before surgery (4 patients). A gamma probe was used intraoperatively. A SLN was defined as any blue node and/or any node with ex-vivo counts 10x higher than the axillary background. SLNs were assessed intraoperatively by touch prep cytology. Completion ALND was performed in 4 patients. RESULTS: Table 1 summarizes primary tumor characteristics. A mean of 2.2 SLNs per patient was encountered. Lymphoscintigraphy identified SLNs in 4/6 patients preoperatively. Using the gamma probe, SLNs were identified in 5/6 patients. Dye injection identified SLNs in 6/6 patients. Overall, successful SLN localization was accomplished in all cases combining both techniques. Touch prep cytology reports correlated with the final pathological analysis in 6/6 patients. Patients with negative SLNs had no positive nodes in the completion ALND specimens. One patient with a positive SLN had 3 additional positive nodes in the completion ALND specimen. CONCLUSIONS: These data compare favorably with the available literature for SLN biopsy in female breast cancer patients. Blue dye injection and lymphatic mapping were complementary. Performance of SLN biopsy should be considered for the staging of the axilla in male breast cancer patients with clinically negative axillas, SLN biopsy reduces the number of unnecessary ALNDs and could increase the accuracy of the staging of the axilla in these patients. Patienl # 1 2 3 4 5 6 Primary 3.8cm 1.7cm 0.5cm 1.5cm 1.4cm 2.5cm Tumor IDC IDC IDC IDC IDC IDC Pathology Grade 3 Grude 2 Grade 2 Grade 2 Grade 2, Grade 2 ER/PR + ER +; PR - ER +; PR - ER +; PR - ER +; PR - ER/PR + her-2/neu - her-2/neu + her-2/neu -.

Original languageEnglish (US)
Number of pages1
JournalBreast Cancer Research and Treatment
Volume69
Issue number3
StatePublished - Dec 1 2001
Externally publishedYes

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Male Breast Neoplasms
Axilla
Lymph Node Excision
Sentinel Lymph Node Biopsy
Lymphoscintigraphy
Biopsy
Touch
Breast Neoplasms
Cell Biology
Coloring Agents
Technetium Tc 99m Sulfur Colloid

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Albo, D., Ames, F. C., Hunt, K. K., Ross, M. I., Singletary, S. E., & Kuerer, H. M. (2001). Lymphatic mapping for male breast cancer. Breast Cancer Research and Treatment, 69(3).

Lymphatic mapping for male breast cancer. / Albo, Daniel; Ames, F. C.; Hunt, K. K.; Ross, M. I.; Singletary, S. E.; Kuerer, H. M.

In: Breast Cancer Research and Treatment, Vol. 69, No. 3, 01.12.2001.

Research output: Contribution to journalArticle

Albo, D, Ames, FC, Hunt, KK, Ross, MI, Singletary, SE & Kuerer, HM 2001, 'Lymphatic mapping for male breast cancer', Breast Cancer Research and Treatment, vol. 69, no. 3.
Albo D, Ames FC, Hunt KK, Ross MI, Singletary SE, Kuerer HM. Lymphatic mapping for male breast cancer. Breast Cancer Research and Treatment. 2001 Dec 1;69(3).
Albo, Daniel ; Ames, F. C. ; Hunt, K. K. ; Ross, M. I. ; Singletary, S. E. ; Kuerer, H. M. / Lymphatic mapping for male breast cancer. In: Breast Cancer Research and Treatment. 2001 ; Vol. 69, No. 3.
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abstract = "OBJECTIVE: Sentinel lymph node biopsy (SLNB) is emerging as an alternative to axillary lymph node dissection (ALND) for many female breast cancer patients. In contrast, ALND remains the standard of care tor male breast patients with similar tumors. We evaluated the results of SLNB in male breast cancer patients with clinically negative axillas. METHODS: The patient population consisted of six consecutive male breast cancer patients, ages 44 to 76 years old, treated at our institution. All patients had negative axillas by clinical exam and ultrasound. Preoperative lymphoscintigraphy was used in all cases. In each patient, 5 cc of isosulfan blue 1{\%} was injected intraoperatively adjacent to the breast tumor or biopsy cavity prior to SLNB. Additionally, Tc-99m sulfur colloid was injected at a dose of 0.5 mCi 4 hours before surgery (2 patients) or 2.5 mCi 24 hours before surgery (4 patients). A gamma probe was used intraoperatively. A SLN was defined as any blue node and/or any node with ex-vivo counts 10x higher than the axillary background. SLNs were assessed intraoperatively by touch prep cytology. Completion ALND was performed in 4 patients. RESULTS: Table 1 summarizes primary tumor characteristics. A mean of 2.2 SLNs per patient was encountered. Lymphoscintigraphy identified SLNs in 4/6 patients preoperatively. Using the gamma probe, SLNs were identified in 5/6 patients. Dye injection identified SLNs in 6/6 patients. Overall, successful SLN localization was accomplished in all cases combining both techniques. Touch prep cytology reports correlated with the final pathological analysis in 6/6 patients. Patients with negative SLNs had no positive nodes in the completion ALND specimens. One patient with a positive SLN had 3 additional positive nodes in the completion ALND specimen. CONCLUSIONS: These data compare favorably with the available literature for SLN biopsy in female breast cancer patients. Blue dye injection and lymphatic mapping were complementary. Performance of SLN biopsy should be considered for the staging of the axilla in male breast cancer patients with clinically negative axillas, SLN biopsy reduces the number of unnecessary ALNDs and could increase the accuracy of the staging of the axilla in these patients. Patienl # 1 2 3 4 5 6 Primary 3.8cm 1.7cm 0.5cm 1.5cm 1.4cm 2.5cm Tumor IDC IDC IDC IDC IDC IDC Pathology Grade 3 Grude 2 Grade 2 Grade 2 Grade 2, Grade 2 ER/PR + ER +; PR - ER +; PR - ER +; PR - ER +; PR - ER/PR + her-2/neu - her-2/neu + her-2/neu -.",
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AU - Albo, Daniel

AU - Ames, F. C.

AU - Hunt, K. K.

AU - Ross, M. I.

AU - Singletary, S. E.

AU - Kuerer, H. M.

PY - 2001/12/1

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N2 - OBJECTIVE: Sentinel lymph node biopsy (SLNB) is emerging as an alternative to axillary lymph node dissection (ALND) for many female breast cancer patients. In contrast, ALND remains the standard of care tor male breast patients with similar tumors. We evaluated the results of SLNB in male breast cancer patients with clinically negative axillas. METHODS: The patient population consisted of six consecutive male breast cancer patients, ages 44 to 76 years old, treated at our institution. All patients had negative axillas by clinical exam and ultrasound. Preoperative lymphoscintigraphy was used in all cases. In each patient, 5 cc of isosulfan blue 1% was injected intraoperatively adjacent to the breast tumor or biopsy cavity prior to SLNB. Additionally, Tc-99m sulfur colloid was injected at a dose of 0.5 mCi 4 hours before surgery (2 patients) or 2.5 mCi 24 hours before surgery (4 patients). A gamma probe was used intraoperatively. A SLN was defined as any blue node and/or any node with ex-vivo counts 10x higher than the axillary background. SLNs were assessed intraoperatively by touch prep cytology. Completion ALND was performed in 4 patients. RESULTS: Table 1 summarizes primary tumor characteristics. A mean of 2.2 SLNs per patient was encountered. Lymphoscintigraphy identified SLNs in 4/6 patients preoperatively. Using the gamma probe, SLNs were identified in 5/6 patients. Dye injection identified SLNs in 6/6 patients. Overall, successful SLN localization was accomplished in all cases combining both techniques. Touch prep cytology reports correlated with the final pathological analysis in 6/6 patients. Patients with negative SLNs had no positive nodes in the completion ALND specimens. One patient with a positive SLN had 3 additional positive nodes in the completion ALND specimen. CONCLUSIONS: These data compare favorably with the available literature for SLN biopsy in female breast cancer patients. Blue dye injection and lymphatic mapping were complementary. Performance of SLN biopsy should be considered for the staging of the axilla in male breast cancer patients with clinically negative axillas, SLN biopsy reduces the number of unnecessary ALNDs and could increase the accuracy of the staging of the axilla in these patients. Patienl # 1 2 3 4 5 6 Primary 3.8cm 1.7cm 0.5cm 1.5cm 1.4cm 2.5cm Tumor IDC IDC IDC IDC IDC IDC Pathology Grade 3 Grude 2 Grade 2 Grade 2 Grade 2, Grade 2 ER/PR + ER +; PR - ER +; PR - ER +; PR - ER +; PR - ER/PR + her-2/neu - her-2/neu + her-2/neu -.

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