The need for second surgery due to compromised margins is not common, with variable residual tumor identifying ranges. Some pathological factors can predict the persistence of residual disease. In our series, tumor size >3 cm was the variable identified as an independent predictor.

Antecedentes: dada la mayor disponibilidad de estudios genéticos, en los últimos años se incrementaron significativamente las mastectomías de reducción de riesgo (MRR). Objetivo: analizar la experiencia institucional en MRR. Material y métodos: se tuvieron en cuenta las pacientes sanas sometidas a MRR bilateral simultánea y también las pacientes con antecedentes de cáncer de mama que luego fueron sometidas a MRR contralateral. No fueron tenidas en cuenta las mastectomías realizadas como tratamiento actual de un cáncer, pero sí la mastectomía contralateral. Resultados: se realizaron 70 MRR en 49 pacientes que cumplían con los criterios de inclusión para el análisis. La edad promedio fue de 44 años (rango 34-64). En 60 casos se conservó el complejo areolapezón. En 50 casos, la reconstrucción mamaria fue con implante protésico directo. En 57 pacientes la incisión fue radiada en cuadrante superoexterno. En 57 casos no presentaron complicaciones y, de las restantessolo en 1 (1,4%) se perdió el implante. En un solo caso se detectó un carcinoma de mama oculto, y, en la evolución, una paciente desarrolló un carcinoma pequeño en la mama operada. Conclusión: la MRR es una alternativa válida y segura en mujeres con alto riesgo de cáncer de mama, pues logra disminuir en forma significativa la probabilidad de padecer la enfermedad, con buenos resultados estéticos y alto nivel de satisfacción.

Objetive 1. - To compare the capacity of the PET and the sentinel node for the detection of axillary metastasis (MTS). 2. - To evaluate sensitivity, specificity, positive and negative predictive value of the PET/CT. Inclusion criteria-Breast cancer T1 T2 NO. Palpable nodes suspicious of involvement. Exclusion criteria-Ductal carcinoma in situ, inflammatory carcinoma, recent biopsy of the breast, pregnancy or lactation, diabetes. Method 18-FDG PET/CT was made 15 days before the surgery. The sentinel node biopsy took place with the combined method (radioisotopes and patent blue) Material They were evaluated 54 patients. Age average: 59 years (37-79). T1: 36 patients (67%); T2: 18 patients (33%) Tumor size between 5 and 40 mm (average 19) clinically negative axilla 46 (85%); doubtful axilla 8 (15%). Stage I: 33 patients (61%); stage II: 21 patients (39%). Results Forty four (81%) of the tumors were invasive ductal carcinoma: 7 (13%) invasive lobular carcinoma; and 3 (6%) ductolobular. Fifteen patients had MTS in the SN (28%), of these 3 were micrometastasis. In 2 patients the PET/CT changed the stage since it was positive for bony and pulmonary MTS. Results PET in breast: Eleven negatives (FN: 20%). Four were invasive lobular carcinomas; 4 were T1a. Sensitivity 80%. VPP = 100%. False negative: 20%Result PET in axila: In 45 patients the PET was negative (83%). Six of them presented MTS in the sentinel node; 3 of them were micrometastasis. False negative: 40%. Sensitivity: 60%.VPN 87%. In 9 patients the PET were positive (17%) and the sentinel node was positive in all the cases. Specifity: 100%. VPP = 100%. In 8 patients the axilla was doubtful, of these only in one patient PET and the SN was positive. Conclusion 1.-PET/CT does not contribute advantages for the axillary staging in the initial stage because it does not manage to identify smaller MTS of 5 mm. 2.- A negative PET/CT does not replace the sentinel node biopsy. 3.- A positive PET/CT would indicate the necessity of making an axillary dissection still in clinically negative axilla. 4- In clinically doubtful axilla was coincidence between PET/CT and the SN as much in the negatives as in the positives. Key words: Occult axillary metastases. Positron emission tomography. Sentinel node biopsy. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-28.

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OBJETIVE To evaluate the 18F-FDG PET/CT capacity for the detection of axillary metastases and compare results with sentinel lymph node biopsy (SLNB).MATERIAL AND METHODS: 99 female patients with clinical T1T2N0 breast cancer were included. Patients with recent breast or axillary surgery, T3T4 disease, ductal carcinoma in situ, inflammatory carcinoma, uncontrolled diabetes mellitus and pregnant or lactation patients were excluded. Pre-operative FDG PET-CT was performed 15 days before surgery, SLNB took place with the combined method (radioisotopes and patent blue). Pearson and Spearman correlation test were used to evaluate association of main variables with a significance level (p) of 0.05.RESULTS: Breast PET-CT results: 80 positive PET/CT. Negative PET/ CT in 19 patients (4invasive lobular carcinoma, 7 tumors <7mm) Sensitivity 81%, specificity 100%.97 patients were operated (2 were stage IV with no surgery criteria). We found significant correlation of the FDG tumor uptake (SUV) with tumor size (p< 0.0001), histological grade (p< 0.009), nuclear grade (p<0.001), mitotic grade (p< 0.007) and Ki 67 (p< 0.0001).In all cases the correlation was positive.There was no correlation with hormonal receptors rate.Axillary PET CT results: positive PET/CT in 16 patients (16%). Of this 6 SNLB were negative (FPR= 9%). Specificity 91%, PET /CT were negative in 81 patients (84%), 17 had axillary metastases(5 micrometastases, 2 isolated tumor cells and 2 lobular carcinoma).Sensitivity:37%.FNR=63%. Correlation of histopatological axillary metastases was positive with breast tumor SUV (P<0.0002) and tumor size (p<0.01), but was not significant with histological, nuclear and mitotic grade, Ki 67,hormonal receptor rate and molecular subtype CONCLUSION: 1- PET / CT does not provide benefits for axillary staging in initial stages due to its low spatial resolution (6-8 mm) 2 –A negative axillary by PET/CT does not replace the sentinel node technique. 3 – We can suspect the presence of axillary metastases when there is an intense FDG uptake in the breast tumor. Citation Format: Cristina Noblia, Eugenia Azar, Dolores Mansilla, Amilcar Osorio, Eduardo Armanasco, Diana Montoya, Martin Ipiña, Gaston Berman, Eduardo Gonzalez, Christian Gonzalez, Gabriel Bruno, Patricia Parma, Carla Pulero, Ana Alvarez. Role of 18 FDG PET/CT in axillary staging in early breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-01-16.