Sentinel lymph node biopsy in patients with locally advanced breast cancer after neoadjuvant chemotherapy

Aguiar, Paulo Henrique Walter; Pinheiro, Luiz Gonzaga Porto; Mota, Rosa Maria Salani; Margotti, Nair Hermínia Gurjão; Rocha, João Ivo Xavier

doi:10.1590/s0102-86502012001200014

Cited by 10 publications

(4 citation statements)

References 17 publications

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“…Another study comparing imprint cytology with the histological analysis of SLNs from patients with locally advanced breast cancer subjected to neoadjuvant chemotherapy concluded that imprint cytology could not be recommended given the high rate of false negatives (12.01%) observed in the study. Therefore, further studies are required to validate the method 26 .…”

Section: Discussionmentioning

confidence: 99%

Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy

Bocanegra¹,

Millen²,

Nascimento³

et al. 2018

Clinics

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OBJECTIVES:To compare imprint cytology and paraffin section histology for sentinel lymph node detection in women with breast cancer treated with neoadjuvant chemotherapy.METHOD:A cross-sectional study and report of the sentinel lymph node statuses of 64 patients with breast cancer who underwent intraoperative imprint cytology and neoadjuvant chemotherapy in a referral cancer institute in Rio de Janeiro, Brazil, between 2014 and 2016.RESULTS:The mean age was 51 years. The most common histological type was invasive ductal carcinoma (93.75%), and the most common differentiation grade was 2 (62.5%). Overall, 153 lymph nodes were identified, with a mean of 2.39/case. Thirty-four lymph nodes tested positive for malignancy by imprint cytology, and 55 tested positive by histology. Of the 55 positive lymph nodes, 41 (74.5%) involved macrometastases, and 14 (25.5%) involved micrometastases. There were 21 false negatives with imprint cytology, namely, 7 for macrometastases and 14 for micrometastases, resulting in a rate of 17.6%. The sensitivity of imprint cytology was 61.8%, with a specificity and positive predictive value of 100%, a negative predictive value of 82.4% and an accuracy of 86.3%. The method presented null sensitivity for the identification of micrometastases.CONCLUSIONS:The false-negative rate with imprint cytology was associated with the number of sentinel lymph nodes obtained. The rate found for complete response to neoadjuvant chemotherapy was comparable to the rates reported in the literature. The accuracy of imprint cytology was good, and its specificity was excellent for sentinel lymph node detection; however, the method was unable to detect lymph node micrometastases.

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Section: Discussionmentioning

confidence: 99%

Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy

Bocanegra¹,

Millen²,

Nascimento³

et al. 2018

Clinics

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“…In our hospital, we only have blue dye (patent blue) available, and we conducted this cross-sectional study to demonstrate the detection rate of SLN using it to reflect a real-world evidence. Our SLN detection rate was of 85.3%, which would be acceptable, comparing with National Surgical Adjuvant Breast and Bowel Project (NSABP) B-27, with identification and removal of a sentinel lymph node of 84.8%, SENTINA arm C (80.1%), ACOSOG 1071 (92.7%), and Aguiar (85.3%) [5][6][7][8]18 . Although it would be possible to calculate FNR in our study (25%), the small sample size might overestimate this rate.…”

Section: Resultsmentioning

confidence: 78%

Sentinel lymph node biopsy using single-agent mapping tracer (blue dye) after neoadjuvant chemotherapy in a Brazilian cohort of breast cancer patients. Real world evidence

Resende

Lichtenfels

Soares³

et al. 2021

Acta Cir. Bras.

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To reduce false-negative rates (FNR) in sentinel lymph node biopsy (SLNB) of clinically positive (cN+) axilla in patients undergoing neoadjuvant chemotherapy (NAC). The removal of three or more lymph nodes with dual-tracer mapping including a radioisotope was used. However, in the Brazilian Unified Health System, the radioisotope tracer is not feasible in some hospitals. We conducted a crosssectional study to evaluate the detection rate of sentinel lymph node (SLN) in patients who converted from cN+ to ycN0 after NAC using blue dye as a single-agent mapping tracer. Methods: During the period of March 2018 to September 2019, 34 patients who underwent NAC with cN+ who converted to ycN0 were enrolled in the study. The SLNB was performed using blue dye as a single-agent mapping followed by axillary lymph node dissection (ALND). Results: The detection rate of sentinel lymph node was of 85.3%, being SLNB not possible for five patients (14.7%), due to fibrosis. The mean number of removed SLN was 2.5. Conclusions: The use of blue dye as a single-agent mapping tracer demonstrated an acceptable detection rate of 85.3%. Although the FNR was possible to be determined, the small sample size might overestimate this rate. The removal of three or more lymph nodes with single-agent mapping tracer might be indicated for breast cancer patients who converted to ycN0 after NAC in the Brazilian health public services, in which radioisotope tracer is not suitable.

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“…The most common descriptions brought together pro/retrospective with population origin (cohort/case-control/consecutive patients), and pro/retrospective with crosssectional, and pro/retrospective with number of centres, with 6 shorthand descriptions each. The longest descriptions were "a cross-sectional validation of diagnostic test" 24 and "cross-sectional, multicentre, non-interventional study" 25 . Both studies clearly indicated their purpose to be to measure diagnostic accuracy.…”

Section: Shorthand Descriptions Of Study Design -First Review Exercisementioning

confidence: 99%

It was not easy to identify the study design from the title and abstract of articles indexed as diagnostic (test) accuracy studies in EMBASE in 2012 and 2019

Thompson

Zhelev

Hunt

et al. 2022

Journal of Clinical Epidemiology

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Sentinel lymph node biopsy in patients with locally advanced breast cancer after neoadjuvant chemotherapy

Cited by 10 publications

References 17 publications

Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy

Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy

Sentinel lymph node biopsy using single-agent mapping tracer (blue dye) after neoadjuvant chemotherapy in a Brazilian cohort of breast cancer patients. Real world evidence

It was not easy to identify the study design from the title and abstract of articles indexed as diagnostic (test) accuracy studies in EMBASE in 2012 and 2019

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