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Sentinel Node Biopsy During Pregnancy

Sentinel Node Biopsy During Pregnancy

Question

Dear OncoLink "Ask The Experts,"

I have recently been diagnosed with melanoma: 0.77 mm thick with Clark 's level IV. I am also 7 weeks pregnant. I am scheduled for a wide excision with local anesthetic for this Friday. Is there a time in pregnancy when the sentinel node biopsy (SNB) can be performed with minimal risk to the fetus from the radioactive dye and general anesthetic?

Answer

Suzanne M. McGettigan, MSN, CRNP, AOCN, Board Certified Adult Nurse Practitioner and a Certified Oncology Advanced Practice Nurse, responds:

There were a few studies performed at Sloan Kettering that found sentinel node biopsy to be a safe procedure during pregnancy in breast cancer patients. For breast cancer, the SNB is performed in the axillary region (armpit area). Only a local anesthetic and the radioactive tracer are used, but not the blue dye. For some reason, the blue dye crosses the placenta and can be harmful to the fetus, while the radioactivity has not been detectable near the fetus. This information translates easily to the procedure used in melanoma; however, there are not any studies examining the use of SNB specifically in the inguinal region (groin area). Therefore, the safety of the SNB would ultimately depend on where it is performed in the body, which in turn depends on where the melanoma was located.