RCB determined from routine pathologic materials represented the distribution of RD, was a significant predictor of DRFS, and can be used to define categories of near-complete response and chemotherapy resistance.

The use of sentinel lymph node surgery after neoadjuvant chemotherapy for patients who present with cN1 breast cancer provides an opportunity to avoid axillary lymph node dissection for those patients who have eradication of their nodal disease with chemotherapy. Since the initial publication of prospective trials demonstrating the false-negative rate of sentinel lymph node (SLN) surgery in this setting, this practice has been increasing. [1][2][3][4] A recent survey of the American Society of Breast Surgeons (ASBrS) reported that 85% of respondents offered SLN surgery to some patients in this setting. 5

Neoadjuvant chemotherapy has the capacity to completely clear the breast and axillary lymph nodes of invasive tumor before surgery. Patients with LABC who have a pCR in the breast and axillary nodes have a significantly improved disease-free survival rate. However, a pCR does not entirely eliminate recurrence. Further efforts should focus on elucidating the molecular mechanisms associated with this response.

Marking nodes with biopsy-confirmed metastatic disease allows for selective removal and improves pathologic evaluation for residual nodal disease after chemotherapy.

No abstract