Sentinel lymph node biopsy can be performed in previous breast augmentation patients
June 25th, 2009 Dr. McKaneSome of my patients ask me what will happen to them if they develop a breast cancer after undergoing aesthetic breast surgery. They wonder if they will be a candidate for breast conservation therapy and sentinel lymph node biopsy. As more and more breast surgery is performed, unfortunately, more and more women will be confronted with this problem.
Sentinel lymph node biopsy is used to stage the spread of breast cancer. It is a technique by which the “sentinel” or first lymph node to collect the lymphatic fluid draining from the breast is examined for the presence of metastasis. If breast cancer is present in this lymph node, a formal lymph node dissection is performed as there is a reasonable chance that the cancer has spread to additional lymph nodes in the arm pit or axilla. If no cancer is present here, oncologists can be reasonably certain that the cancer has not spread beyond the local site in the breast and a formal axillary lymph node dissection is avoided.
In patients who have had past breast surgery, the sentinel lymph node biopsy technique was contraindicated due to a hypothesized risk that the breast lymphatics were divided and that this would lead to an inability to accurately identify the sentinel node. Recent studies have suggested that this may not be the case and that the procedure can be appropriately performed. Fernandez et al. evaluated 70 patients who underwent breast augmentation via an inframammary or periareolar approach or a breast reduction that ultimately developed breast cancer. These patients underwent a sentinel lymph node biopsy as part of their cancer staging. The sentinel node was identified in 100% of these patients and none of them went on to develop recurrence of the tumor in their axilla at 19 months of follow up. This article suggests that sentinel lymph node biopsies can safely and appropriately be performed in women who have undergone previous breast augmentation or breast reduction.
Our websites, www.beauty-surgeon.com and www.drmckane.com have additional information and before and after photographs of breast augmentation and breast reduction for review. I invite you to schedule a consultation with me if you would like to learn more about breast augmentation, breast reduction, or breast conservation surgery. Please feel free to contact our office at (713) 661-5255 if you have any questions.
-Brice W. McKane, M.D.