Sentinel lymph node biopsy in patients with male breast carcinoma

BACKGROUND. Sentinel lymph node biopsy (SLNB) is now a widely implemented t echnique for evaluating the axilla in women with early stage breast carcino ma. Men who develop breast carcinoma are at similar risk as their female co unterparts of developing the morbidities related to axillary dissection. SL NB is aimed at preventing these morbidities. In this study, the authors eva luated the role of SLNB in the treatment of men with early stage breast car cinoma. METHODS. Among the 1692 patients who underwent SLNB at the Memorial Sloan-K ettering Cancer Center, 16 men with breast carcinoma were identified. The c harts and records of these 16 patients were reviewed retrospectively. RESULTS. The mean patient age was 57.2 years. The mean tumor size was 1.3 c m. In 15 of 16 patients (93.75%) and in all patients with Ti tumors, one or more sentinel lymph nodes were successfully identified. SLNB failed in one patient, who had a T2 tumor (3 cm). Ten of the 15 patients had negative se ntinel lymph nodes (66.7%). Four of these patients had no additional lymph nodes removed, whereas six patients had additional lymph nodes removed, all of which were negative. Two patients (13.3%) had positive sentinel lymph n odes on frozen-section analysis and underwent immediate completion axillary dissection: Both had additional positive lymph nodes. Three patients (20.0 %) had positive sentinel lymph nodes on further sectioning or immunohistoch emistry, and two patients underwent completion axillary dissection: Neither patient had additional positive lymph nodes. The third patient had one imm unohistochemically positive lymph node and did not undergo completion axill ary dissection. CONCLUSIONS. SLNB for patients with breast carcinoma was as successful in m en as it has been shown to be in women and may be offered as a management o ption to men with early stage breast carcinoma by surgeons who are experien ced with the technique. (C) 20001 American Cancer Society.