<p>Clinical Practice Status of Sentinel Lymph Node Biopsy for Early-Stage Breast Cancer Patients in China: A Multicenter Study</p>

Abstract

Background: Sentinel lymph node biopsy (SLNB) was introduced over 30 years ago, but the application of SLNB in China is unclear. This study aimed to explore the real-world implementation of SLNB among early-stage breast cancer patients in China. Methods: A multi-center, retrospective study was conducted among primary breast cancer patients from 37 hospitals in China in 2018. Their clinical data were collected and analyzed, including the implementation status of SLNB in China, subsequent processing of sentinel lymph nodes (SLNs) containing metastases, and the effect of neoadjuvant chemotherapy (NAC) on SLNB. Results: SLNB surgery was performed on 43.5% of early-stage breast cancer patients in China and 11,942 patients who underwent SLNB were enrolled in this study. The majority of SLNBs were performed using a single mapping agent. A combination of blue dye and radiotracer or fluorescence imaging was used in only 14.9% of patients. The mean (SD) number of resected SLNs was 4.0 (2.1). For the patients with 1 or 2 positive SLNs, 83.0% of them continued to receive axillary lymph node dissection (ALND), while others did not. For the patients with three or more positive SLNs, 97.2% of them continued to receive ALND, among which 82.9% accepted radiotherapy simultaneously. Of the patients who underwent SLN surgery, 5.5% (654/11,942) were receiving NAC. Among them, 51.9% received SLNB before NAC, and the rest received SLNB after NAC. In biopsy-proven positive nodes, 64.7% positive SLNs turned negative after NAC. Conclusion: SLNB has been promoted in China, but it is not widely used compared to in developed countries. Furthermore, the usage of the dual tracer technique in SLNB is not high. Chinese breast surgeons are more conservative regarding the omission of ALND in 1 or 2 SLNs-positive patients.

Role of Hormonal Receptor in Predicting Sentinel Lymph Node Metastasis in Early Breast Cancer

“…In the wake of restricting itself in the lymphatic organization, a glimmer counter is used to decide SLN which acknowledges the central waste from the tumor through a lymphatic circulation (vessel). The blue staining will help with confinement after entry point and nodes that are blue, radioactive, or both are perceived as SLN, subsequently taken out and inspected ( 5 ).…”

“…Eighty percent of women who underwent axillary dissection experienced complications like a decrease of mobility, seroma, paresthesia or lymphedema, ipsilateral pain where these complications are difficult to manage and may affect the quality of life significantly ( 4 ). Brar et al reported that 60% of patients complained about one or more complications, therefore a newer and non-invasive method has been used such as sentinel lymph node biopsy (SLNB) that has lower morbidity and mortality rate compare to ALND ( 5 ).…”

Analysis of sentinel lymph node biopsy and non-sentinel lymph node metastasis in invasive ductal and invasive lobular breast cancer: a nationwide cross-sectional study (CSBrS-001)

“…The SLNB technique and classification of molecular subtype were performed as described in our previous study (18). The CSBrS issued a unified data collection form to 37 medical centers in China and defined the classification criteria in the collection form.…”

“…It remains controversial whether IDC or ILC has a higher risk of non-SLNs involvement, and there is little information regarding the implementation of SLNB in patients with ILC. In our previous study, we described implementation status of SLNB and subsequent processing of positive SLNs among breast cancer patients in China (18). To explore the aforementioned issues, this nationwide cross-sectional study compared the involvement of SLNs and non-SLNs between patients with IDC and ILC.…”

Retrospective analysis of sentinel lymph node biopsy using methylene blue dye for early breast cancer

“…[ 3 ] In 2020, the Chinese Society of Breast Surgeons of the Chinese Medical Association conducted a 37-hospital retrospective analysis and found that methylene blue dye (MBD) was used as the only tracer in more than 70% of SLNBs in breast cancer patients in China. [ 4 ] To investigate the clinical SLN identification rate (IR) using MBD and to calculate the false-negative rate (FNR) in frozen sections, we retrospectively analyzed the clinicopathological data of patients with early breast cancer who underwent SLNB with MBD at the Peking University First Hospital between January 2013 and December 2018.…”