Our Summary

This study aimed to understand the impact of a particular kind of biopsy called a sentinel lymph node biopsy (SLNB), performed at the same time as a type of breast reconstruction surgery that uses implants and tissue expanders. The researchers compared this to the same type of reconstruction surgery without the biopsy.

The study included women who underwent a total mastectomy (removal of the breast) and immediate two-stage implant-based breast reconstruction (IBBR) between 2011 and 2021. The patients were matched in pairs based on age, health conditions, treatments they had previously undergone, the specifics of their surgery, and other factors.

The study found that those who had the SLNB biopsy at the same time as their reconstruction surgery had a higher rate of seroma formation (a pocket of clear serous fluid that sometimes develops in the body after surgery) within 30 days compared to those who didn’t have the biopsy. However, the time it took for the two-stage reconstruction process to be completed and the time it took to swap the tissue expander for the implant were similar in both groups.

The conclusion was that having a SLNB biopsy at the same time as the mastectomy and the initial stage of the two-part breast reconstruction increased the risk of seroma formation. However, the rates of infection, hematoma (a collection of blood outside of the blood vessels), and unplanned procedures to manage complications were similar in both groups.

FAQs

  1. What is a sentinel lymph node biopsy (SLNB) and when is it performed during breast reconstruction surgery?
  2. How does having a SLNB biopsy at the same time as a mastectomy and breast reconstruction affect the rates of seroma formation?
  3. Are there differences in the rates of infection, hematoma, and unplanned procedures between patients who have a SLNB biopsy and those who don’t during a mastectomy and breast reconstruction surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sentinel lymph node biopsy is to be aware of the potential risk of seroma formation after the procedure. Patients should follow post-operative care instructions carefully, including monitoring for any signs of infection or complications, and communicate any concerns with their healthcare provider promptly. It’s important to stay informed and ask questions about the procedure and potential risks before undergoing a sentinel lymph node biopsy.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy include those with early-stage breast cancer who are undergoing a mastectomy and immediate breast reconstruction surgery. This procedure is often recommended for patients who have a high risk of lymph node involvement, as it helps determine whether cancer has spread to the lymph nodes and can guide further treatment decisions. Additionally, patients who have previously undergone chemotherapy or radiation therapy may also be recommended for a sentinel lymph node biopsy to assess the effectiveness of their treatment and to monitor for any signs of cancer recurrence.

Timeline

Before the sentinel lymph node biopsy:

  • Patient undergoes a total mastectomy to remove the breast
  • Patient is scheduled for immediate two-stage implant-based breast reconstruction surgery
  • Patient may be informed about the option of having a sentinel lymph node biopsy at the same time as the reconstruction surgery

After the sentinel lymph node biopsy:

  • Patient undergoes the biopsy procedure during the reconstruction surgery
  • Within 30 days, patient may experience a higher rate of seroma formation compared to those who did not have the biopsy
  • The two-stage reconstruction process is completed similarly in both groups
  • Patient may require additional procedures to manage complications, although rates of infection, hematoma, and unplanned procedures are similar in both groups

Overall, the study suggests that while having a sentinel lymph node biopsy during breast reconstruction surgery may increase the risk of seroma formation, other complications and the overall timeline of the reconstruction process are comparable to those who do not have the biopsy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sentinel lymph node biopsy include:

  1. What is a sentinel lymph node biopsy and why is it recommended for me?
  2. What are the potential risks and complications associated with having a sentinel lymph node biopsy during my breast reconstruction surgery?
  3. How will having a sentinel lymph node biopsy impact the overall timeline and success of my breast reconstruction surgery?
  4. Are there alternative options to consider instead of a sentinel lymph node biopsy during my reconstruction surgery?
  5. How will the results of the biopsy affect my treatment plan and prognosis?
  6. What specific steps will be taken to minimize the risk of complications, such as seroma formation, during and after the surgery?
  7. How experienced is the surgical team in performing sentinel lymph node biopsies during breast reconstruction surgeries?
  8. How will the biopsy impact my recovery process and post-operative care?
  9. Are there any additional tests or procedures that may be necessary based on the results of the biopsy?
  10. What support resources are available to me as I navigate the decision-making process and undergo the biopsy procedure?

Reference

Authors: Escandón JM, Aristizábal A, Christiano JG, Langstein HN, Manrique OJ. Journal: J Plast Reconstr Aesthet Surg. 2023 Sep;84:447-458. doi: 10.1016/j.bjps.2023.06.003. Epub 2023 Jun 9. PMID: 37413737