AB052. SOH24AB_203. Sentinel lymph node biopsy in patients undergoing risk reduction mastectomy: a systematic review and meta-analysis
Systematic Review Session

AB052. SOH24AB_203. Sentinel lymph node biopsy in patients undergoing risk reduction mastectomy: a systematic review and meta-analysis

Yareen Fattah Agha1, Tim Harding1, Matthew Davey2, Michael Kerin2, Michael Boland1

1Department of General Surgery, St. Vincent’s University Hospital, Dublin, Ireland; 2Department of General Surgery, University Hospital Galway, Galway, Ireland

Background: Prophylactic mastectomy is offered to women in the high risk setting to reduce the real or apparent risk of future breast cancer. The utility of performing a sentinel lymph node biopsy (SLNB) at the time of mastectomy remains controversial, with no uniform guidelines available. We performed a systematic review and meta-analysis to assess the benefit, if any, in performing a SLNB during prophylactic mastectomy.

Methods: A systematic review was conducted as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Characteristics predictive of SLNB+ were assessed as dichotomous variables, expressed as odds ratio (OR) with corresponding 95% confidence interval (CI) using the Mantel-Haenszel method. Further analysis, either fixed or random effects models were applied on the bases of whether significant heterogeneity (I2>50%) existed.

Results: A total of 16 studies involving 4,789 patients were included in our study. The total number of mastectomies performed was 3,670. Of these 3,670 mastectomies, a total of 327 prophylactic mastectomies were performed for BRCA (breast cancer gene) positive patients, with the remaining 3,343 mastectomies performed for risk reducing purposes (high risk lesions, positive family history, history contralateral disease). And 360/2,828 (12%) of patients had a SLNB performed, of which 38/2,828 (1.3%) were found to have a positive result (OR: <0.01, 95% CI: 0.00–0.01, P<0.0001, I2=39%).

Conclusions: Routine use of SLNB in patients undergoing prophylactic mastectomy may not be indicated due to low levels of positivity as well as additional morbidity.

Keywords: Breast; mastectomy; prophylactic; risk reducing; sentinel node

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab052
Cite this abstract as: Agha YF, Harding T, Davey M, Kerin M, Boland M. AB052. SOH24AB_203. Sentinel lymph node biopsy in patients undergoing risk reduction mastectomy: a systematic review and meta-analysis. Mesentery Peritoneum 2024;8:AB052.

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