Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2015 Mar;261(3):547-52.
doi: 10.1097/SLA.0000000000000551.

Factors affecting sentinel lymph node identification rate after neoadjuvant chemotherapy for breast cancer patients enrolled in ACOSOG Z1071 (Alliance)

Judy C Boughey  1 , Vera J Suman, Elizabeth A Mittendorf, Gretchen M Ahrendt, Lee G Wilke, Bret Taback, A Marilyn Leitch, Teresa S Flippo-Morton, Henry M Kuerer, Monet Bowling, Kelly K Hunt; Alliance for Clinical Trials in Oncology
Affiliations
Clinical Trial

Factors affecting sentinel lymph node identification rate after neoadjuvant chemotherapy for breast cancer patients enrolled in ACOSOG Z1071 (Alliance)

Judy C Boughey et al. Ann Surg. 2015 Mar.

Abstract

Objective: To evaluate factors affecting sentinel lymph node (SLN) identification after neoadjuvant chemotherapy (NAC) in patients with initial node-positive breast cancer.

Background: SLN surgery is increasingly used for nodal staging after NAC and optimal technique for SLN identification is important.

Methods: The American College of Surgeons Oncology Group Z1071 prospective trial enrolled clinical T0-4, N1-2, M0 breast cancer patients. After NAC, SLN surgery and axillary lymph node dissection (ALND) were planned. Multivariate logistic regression modeling assessing factors influencing SLN identification was performed.

Results: Of 756 patients enrolled, 34 women withdrew, 21 were ineligible, 12 underwent ALND only, and 689 had SLN surgery attempted. At least 1 SLN was identified in 639 patients (92.7%: 95% CI: 90.5%-94.6%). Among factors evaluated, mapping technique was the only factor found to impact SLN identification; with use of blue dye alone increasing the likelihood of failure to identify the SLN relative to using radiolabeled colloid +/- blue dye (P = 0.006; OR = 3.82; 95% CI: 1.47-9.92). The SLN identification rate was 78.6% with blue dye alone; 91.4% with radiolabeled colloid and 93.8% with dual mapping agents. Patient factors (age, body mass index), tumor factors (clinical T or N stage), pathologic nodal response to chemotherapy, site of tracer injection, and length of chemotherapy treatment did not significantly affect the SLN identification rate.

Conclusions: The SLN identification rate after NAC was higher when mapping was performed using radiolabeled colloid alone or with blue dye compared with blue dye alone. Optimal tracer use is important to ensure successful identification of SLN(s) after NAC.

Trial registration: ClinicalTrials.gov NCT00881361.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT diagram
Figure 2
Figure 2
Number of sentinel lymph nodes examined histologically
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220(3):391–398. discussion 398-401. - PMC - PubMed
    1. Nwariaku FE, Euhus DM, Beitsch PD, et al. Sentinel lymph node biopsy, an alternative to elective axillary dissection for breast cancer. Am J Surg. 1998;176(6):529–531. - PubMed
    1. Schlag PM, Bembenek A. Specification of potential indications and contraindications of sentinel lymph node biopsy in breast cancer. Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer. 2000;157:228–236. - PubMed
    1. Chagpar AB, Martin RC, Scoggins CR, et al. Factors predicting failure to identify a sentinel lymph node in breast cancer. Surgery. 2005;138(1):56–63. - PubMed
    1. Straver ME, Meijnen P, van Tienhoven G, et al. Sentinel node identification rate and nodal involvement in the EORTC 10981-22023 AMAROS trial. Ann Surg Oncol. 2010;17(7):1854–1861. - PMC - PubMed

Publication types

Associated data