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. 2015 Jan;47(1):26-33.
doi: 10.4143/crt.2013.208. Epub 2014 Aug 29.

Prospective evaluation of the feasibility of sentinel lymph node biopsy in breast cancer patients with negative axillary conversion after neoadjuvant chemotherapy

Hy-De Lee  1 , Sung Gwe Ahn  1 , Seung Ah Lee  2 , Hak Min Lee  1 , Joon Jeong  1
Affiliations

Prospective evaluation of the feasibility of sentinel lymph node biopsy in breast cancer patients with negative axillary conversion after neoadjuvant chemotherapy

Hy-De Lee et al. Cancer Res Treat. 2015 Jan.

Abstract

Purpose: Tumor response to neoadjuvant chemotherapy (NAC) may adversely affect the identification and accuracy rate of sentinel lymph node biopsy (SLNB). This study was conducted to evaluate the feasibility of SLNB in node-positive breast cancer patients with negative axillary conversion after NAC.

Materials and methods: Ninety-six patients with positive nodes at presentation were prospectively enrolled. (18)Fluorodeoxyglucose-positron emission tomography ((18)F-FDG PET) and ultrasonography were performed before and after NAC. A metastatic axillary lymph node was defined as positive if it was positive upon both (18)F-FDG PET and ultrasonography, while it was considered negative if it was negative upon both (18)F-FDG PET and ultrasonography.

Results: After NAC, 55 cases (57.3%) became clinically node-negative, while 41 cases (42.7%) remained node-positive. In the entire cohort, the sentinel lymph node (SLN) identification and false-negative rates were 84.3% (81/96) and 18.4% (9/49), respectively. In the negative axillary conversion group, the results of SLNB showed an 85.7% (48/55) identification rate and 16.7% (4/24) false-negative rate.

Conclusion: For breast cancer patients with clinically positive nodes at presentation, it is difficult to conclude whether the SLN accurately represents the metastatic status of all axillary lymph nodes, even after clinically negative node conversion following NAC.

Keywords: Breast neoplasms; Neoadjuvant therapy; Predictive value of tests; Sentinel lymph node biopsy.

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Conflict of interest statement

Conflict of interest relevant to this article was not reported.

Figures

Fig. 1.
Fig. 1.
Various treatment outcomes according to axillary node status reflect an uneven tumor response to chemotherapy by each metastatic lymph node. Residual non-sentinel node metastasis after chemotherapy could raise concerns regarding application of sentinel lymph node (SLN) biopsy for patients receiving neoadjuvant chemo- therapy (red arrow).
Fig. 2.
Fig. 2.
Study overview. 18F-FDG PET, 18Fluorodeoxyglucose-positron emission tomography; US, ultrasonography; ALND, axillary lymph node dissection; SLNB, sentinel lymph node biopsy.
See this image and copyright information in PMC

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References

    1. Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–8. - PMC - PubMed
    1. Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T, et al. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol. 2007;8:881–8. - PubMed
    1. Lyman GH, Giuliano AE, Somerfield MR, Benson AB, 3rd, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005;23:7703–20. - PubMed
    1. Schwartz GF, Giuliano AE, Veronesi U, Consensus Conference Committee Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast, April 19-22, 2001, Philadelphia, Pennsylvania. Cancer. 2002;94:2542–51. - PubMed
    1. Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER, et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998;16:2672–85. - PubMed

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