Source: Epilepsy Curr  |  Posted 5 years ago

By Crystal Phend

BALTIMORE, M.D. -- April 10, 2006 -- Sentinel lymph node surgery in men with breast cancer appears to be an appropriate alternative to routine use of the more invasive axillary lymph node dissection, according to a study presented here at the annual meeting of the American Society of Breast Surgeons (ASBS).

Sentinel lymph node (SLN) surgery is safe and actually has a higher yield in men compared to women because men typically present with larger tumor size and higher nodal tumor burden, said lead author Judy C. Boughey, MD, breast surgical oncology fellow, University of Texas M.D. Anderson Cancer Center, Houston, Texas, United States, in a presentation April 7[^]th[].

Male breast cancer accounts for less than 1% of all breast cancers and is likewise rarely reported on in the literature.

In their study, Dr. Boughey and colleagues enrolled 30 men and 2,784 women with breast cancer who underwent mastectomy (or lumpectomy for some of the women) and SLN surgery. When intraoperative evaluation of the SLN indicated malignancy, axillary lymph node dissection was completed.

Men in the study were an average of 62.8 years old; 24 presented with a palpable mass, 4 with nipple inversion and 2 with bloody nipple discharge. Most men presented with T1 or T2 disease (55% and 33%, respectively) although there was T4 disease at presentation in 3%.

All the men had sentinel lymph nodes identified with an average of 3.5 found per patient.

Positive SLNs were found in 27% of the men, with an average metastasis size of 8.6 mm. Of these, 88% were identified using intraoperative touch preparation, which allows immediate completion node dissection.

Axillary lymph node dissection was done for 11 men.

Significantly more men than women harbored additional non-SLN disease when there was a positive SLN (63% vs. 21%).

"Intraoperative evaluation of the SLN should be strongly considered in the surgical management of male breast cancer patients," Dr. Boughey said. "In any case where a SLN cannot be identified, modified radical mastectomy remains the gold standard in men."

[Presentation title: Comparative Analysis of Sentinel Lymph Node Surgery in Male and Female Breast Cancer Patients. Poster Session]