The Accuracy of Sentinel Lymph Node Biopsy after Aesthetic Breast Surgery: A Case Series and a Review of the Literature

In the United States, cosmetic surgical procedures on the breast, both augmentation and reduction, are becoming increasingly common. In the year 2008 alone, breast augmentation was the most commonly performed cosmetic procedure, with 307,230 cases, which signifies a 45% increase from the year 2000. Breast reduction is the fifth most common reconstructive procedure, with 88,732 cases in 2008, signifying a 5% increase since 2000 [1]. As this growing population of women age, the dilemma of the ideal method of breast cancer treatment continues to be controversial. Data are limited regarding the morbidity of breast conservation therapy (BCT) in previously augmented women, but some reports indicate that as many as 50% of previously augmented women undergoing BCT have complications that ultimately result in implant removal and mastectomy [2]. Also, there are limited studies on the efficacy of sentinel lymph node biopsy (SLNB) in augmented women. For these two reasons, the preferred treatment for breast cancer in women with breast augmentation has been skin-sparing mastectomy with axillary dissection, and immediate reconstruction. There have been even fewer case reports of the success rate of SLNB in women who have undergone reduction mammoplasty. We report four cases of women who underwent a variety of cosmetic breast procedures and subsequently have gone on to have successful lumpectomy/mastectomy and SLNB. We also performed a literature search in Medline from 1996 to 2010 using the key words “breast cancer, sentinel lymph node biopsy, augmentation, reduction mammoplasty.” These case reports lay the foundation for a literature review about the current opinions and practices of cosmetic and oncologic breast