Sentinel lymph node biopsy in breast cancer after neoadjuvant chemotherapy. A pilot study

Feasibility and Accuracy of Sentinel Lymph Node Biopsy After Preoperative Chemotherapy in Breast Cancer Patients With Documented Axillary Metastases

“…Unlike previously reported studies of lymphatic mapping and SLN biopsy, [1][2][3][4][5][6][7][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] the patients in the current study all had cytologically documented positive lymph nodes at the time of initial presentation. Although SLN identification technically was feasible, the false-negative rate of 25% reported here is much higher than that reported for other series on lymphatic mapping in breast cancer.…”

“…Nevertheless, published retrospective reviews of singleinstitution experiences and multicenter series and a recent meta-analysis have shown that SLN identification rates and false-negative rates after preoperative chemotherapy are comparable to the rates reported in patients who did not receive preoperative chemotherapy. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Preoperative chemotherapy with anthracycline, cyclophosphamide, and taxane-containing regimens has been shown to sterilize involved axillary lymph nodes in approximately 35% to 40% of patients. 15,16,34 Newer regimens in combination with novel biologics likely will increase the conversion rate even further.…”

“…[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The SLN identification rate was significantly lower in patients who had skin involvement at the time of initial presentation. We observed no significant differences in the SLN identification rate according to age, body mass index, clinical tumor size, tumor location, lymphatic mapping method used, or surgeon experience.…”

“…17,18 To date, 16 single-institution or multicenter, retrospective studies have been published that examined the feasibility and accuracy of SLN biopsy after preoperative chemotherapy. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] SLN identification rates range from 84% to 98%, and reported false-negative rates range from 0% to 20%. The overall accuracy of SLN biopsy after preoperative chemotherapy for breast cancer ranges from 88% to 100%.…”

The feasibility and accuracy of sentinel lymph node biopsy in clinically node‐negative patients after neoadjuvant chemotherapy for breast cancer—a systematic review and meta‐analysis

“…These patients had SLNB prior to completion ALND. All 10 were singleinstitution studies, with 5 from the USA [21][22][23][24]26], 2 from Japan [27,28], and 1 each from Brazil [25], Israel [30], and Taiwan [29]. Most studies reported the age of patients studied and patient groups were found to be representative of the clinical population at risk.…”