European Journal of Breast Health (Apr 2011)
THE ROLE OF LYMPHOSCINTIGRAPHY AND SENTINEL LYMPH NODE BIOPSY IN PATIENTS DIAGNOSED AS BREAST CANCER DURING PREGNANCY
Abstract
Breast cancer is one of the most diagnosed malignancies during pregnancy. The prevalence of breast cancer associated with pregnancy is estimated at 1:3,000 deliveries and predicted to increase permanently due to the trend to defer childbearing to older ages. Although breast cancer is generally diagnosed in advanced stage during pregnancy, the treatment modality should be as similar as possible with non pregnant women. In non-pregnant women with early stage invasive breast cancer, axillary lymph node status is the most important prognostic factor for determination of accurate adjuvant treatment. Axillary lymph node dissection is associated with significant morbidity and the sentinel lymph node biopsy is performed using blue dye or lymphoscintigraphy with a radiocolloid. Blue dyes are classified as pregnancy class C drugs and lymphoscintigraphy with a radiocolloid is generally used for the sentinel lymph node biopsy during pregnancy in patients diagnosed with breast cancer. Some technical information should be considered before performing lymphoscintigraphy on breast cancer patients during pregnancy. The lymphoscintigraphy should be performed on the same day of intervention. Sentinel lymph node biopsy can be performed within 2–3 h p.i. with 3–5 MBq of 99m Tc radiocolloid. Diligent perinatal diagnostic examinations should be done to exclude any congenital malformations before performing a lymphoscintigraphy during pregnancy. In conclusion, breast cancer diagnosed during pregnancy is a difficult matter for both the families and physicians but lymphoscintigraphy and sentinel lymph node biopsy may result in optimal treatment for the pregnant breast cancer patients.
