Sentinel Lymph Node Biopsy for Breast Cancer Patients after Neoadjuvant Chemotherapy
|Keywords||Breast cancer Sentinel lymph node Sentinel lymph node biopsy Neoadjuvant chemotherapy|
Objective: To assess the feasibility and accuracy of sentinel lymph node biopsy (SLNB) in breast cancer patients following neoadjuvant chemotherapy (NAG).Methods: A total of 60 consecutive patients with Stage II and III breast cancers,previously treated by NAC, were enrolled in the study. All patients were clinically node-negative after NAC. The patients underwent SLNB,which was mapped with a subdermal injection route over the tumor with methylene blue. This was followed by completion axillary lymph node dissection (ALND). All lymph nodes were examined by routine pathologic examination.Results:1. The outcome of NAC:8 (13.3%) patients achived complete response (CR) ,48 (80.0%) patients achived partial response (PR),4 (6.7%) patients achived stabledisease(SD).There were no PD and pCR patients.2. The outcome of SLNB:SLNB was successful in 55 of 60 patients (detection rate 91.7%). 27 patients (49.1%) had negative nodes on both SLN and non-sentinel lymph node(NSLN), 28 (50.9%) had positive nodes on neither SLN or NSLN. In 5 patients (9.1%),the sentinel node was the only positive node identified. Overall, there was a 94.5%(52/55) concordance between SLN and ALN. There were 3 false negatives in 55 successfully mapped tumors, yielding an FNR of 10.71% (3/28).3. The success rate of sentinel node identification shew no significant difference between the different locations of the tumor,the diffenrent sizes of the tumor befoe NAC,the different axillary lymph node status before NAC and the different clinical response of the tumor afer NAC. Conclusion: Although the SLN identification rate decreased slightly and the false-negative rate increased slightly after neoadjuvant chemotherapy,SLNB could accurately predict axillary status. Thus SLNB can be an alternative to ALND even after neoadjuvant chemotherapy in cases of successful identification of the SLN.