Purpose: We present our experience with sentinel lymph node (SLN) biopsy in men with breast cancer and review the literature published to date. Consecutive men with breast cancer undergoing SLN biopsy were identified in our prospectively maintained database. A PubMed search for "male breast cancer" and "sentinel node biopsy" was performed.
Patients and methods: Thirty patients underwent 31 SLN biopsy procedures between 1996 and 2006. Twenty-five patients presented with a palpable mass, and 13 underwent surgical biopsy for diagnosis. The sentinel lymph node was successfully identified in 90%; 61% of SLN biopsies were positive and, in 65% of this group, the sentinel node was the only positive node.
Results: Combined data from the literature from 110 procedures resulted in an identification rate of 96%, positive sentinel nodes in 45% and the sentinel node as the only positive node in 56%. Only 13 patients underwent completion axillary node dissection after a negative SLN biopsy; none were false negatives. This series extends previous knowledge about SLN biopsy in men with respect to diagnostic biopsy, type of mapping agent, lymphoscintigraphy, and location of injection site. The identification rate mirrors that of large randomized trials of women with breast cancer.
Conclusion: The high rate of lymph node-positive disease, even in this series of patients with clinically node-negative disease, reflects the later presentation of breast cancer in men.