Altering of Biopsy Process Improves Mastectomy Outcomes

To take more time in diagnosing
the first biopsy may be better
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In current practice using sentinel lymph node biopsy (SLNB), the sentinel node is quick-frozen; a pathologist then examines the node under a microscope. This method gives a diagnosis of cancer spread while the surgeon is waiting to complete the procedure.

In the study, 25 patients underwent outpatient sentinel node biopsy, the procedure taking generally less than an hour. The patients then went home. Two patients had cancer in both breasts; therefore, 27 SLNBs were performed. Patients returned for the final pathology results the following week.

The study demonstrated that exact knowledge of positive versus negative sentinel lymph node prior to mastectomy helped physicians plan the optimal surgical procedure for the patient, the researchers said.

Of the 27 biopsies, nine patients (33 percent) had tumour-involved lymph nodes. All nine patients underwent an axillary lymph node dissection at the time of their mastectomy. Of these, three did not have immediate reconstruction because it was thought that would be detrimental, said Dr. Nancy Klauber-DeMore, assistant professor of surgery in University of North Carolina’s School of Medicine.

Of the remaining six node-positive patients, five underwent reconstruction with their own tissue instead of a tissue expander. In contrast, six of the 16 (37 percent) node-negative patients underwent reconstruction with a tissue expander.

“We conclude that performing a sentinel node biopsy as a staged procedure prior to definitive mastectomy and reconstruction gives the treating physicians more information to guide the patient regarding the best surgical procedure for them,” Klauber-DeMore said.

MEDICA.de; Source: University of North Carolina at Chapel Hill School of Medicine