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Published in: Annals of Surgical Oncology 2/2013

01-02-2013 | Melanomas

Sentinel Lymph Node Biopsy for Melanoma in Pregnant Women

Authors: Robert H. I. Andtbacka, MD, CM, Matthew R. Donaldson, MD, Tawnya L. Bowles, MD, Glen M. Bowen, MD, Kenneth Grossmann, MD, PhD, Hung Khong, MD, Douglas Grossman, MD, PhD, Christopher Anker, MD, Scott R. Florell, MD, Anneli Bowen, MD, Keith L. Duffy, MD, Sancy A. Leachman, MD, PhD, R. Dirk Noyes, MD

Published in: Annals of Surgical Oncology | Issue 2/2013

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Abstract

Background

The incidence of melanoma is rising in young women of childbearing age. Melanoma diagnosed during pregnancy presents unique challenges. This study was conducted to determine the effect of sentinel lymph node biopsy (SLNB) for melanoma on maternal and fetal outcomes in pregnant women.

Methods

A prospective melanoma database was retrospectively queried for women diagnosed with melanoma during or immediately before pregnancy as well as SLNB in pregnant women. The outcomes of SLNB for the mothers and fetuses were evaluated.

Results

Fifteen pregnant women underwent wide local excision (WLE) and SLNB for melanoma from 1997 to 2012. The median gestational age was 20 weeks. More than half of the women noticed changes in the primary melanoma lesion during the pregnancy. The median Breslow thickness was 1.00 mm. Lymphatic mapping and SLNB were performed with some combination of radiocolloid or vital blue dye without adverse effects. Three patients had micrometastatic disease and underwent a completion lymphadenectomy. Sixteen children were born at a median gestational age of 39 weeks. The median 1- and 5-minute Apgar scores were 8 and 9, respectively. At a median follow-up of 54.4, months none of the patients had experienced recurrence, and all children were healthy and free of melanoma.

Conclusions

In this series of pregnant women with melanoma, SLNB was performed safely during pregnancy without adverse effects to the mothers and fetuses. We recommend that clinicians explain the risks and benefits of the SLNB procedure to pregnant women so an informed decision can be made about the procedure.
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Metadata
Title
Sentinel Lymph Node Biopsy for Melanoma in Pregnant Women
Authors
Robert H. I. Andtbacka, MD, CM
Matthew R. Donaldson, MD
Tawnya L. Bowles, MD
Glen M. Bowen, MD
Kenneth Grossmann, MD, PhD
Hung Khong, MD
Douglas Grossman, MD, PhD
Christopher Anker, MD
Scott R. Florell, MD
Anneli Bowen, MD
Keith L. Duffy, MD
Sancy A. Leachman, MD, PhD
R. Dirk Noyes, MD
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2633-7

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