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Sentinel lymph node biopsy after neoadjuvant chemotherapy

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Abstract

Background

We surveyed single-center and multi-center studies pertaining to sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy to compare the results with those of our current study to evaluate the feasibility and accuracy of SLNB after neoadjuvant chemotherapy. Methods: From October 2001 to July 2003, 80 patients who had neoadjuvant chemotherapy underwent curative surgery and axillary lymph node dissection (ALND) after SLNB at the Center for Breast Cancer, National Cancer Center. A MEDLINE search was performed using the keywords breast cancer, sentinel lymph node biopsy, and neoadjuvant chemotherapy.

Results

Our results showed that 42 (52.6%) of 80 patients had downstaging of the primary tumor; 9 patients (11.3%) had pathologic complete response (pCR) and 33 (41.3%) had pathologic partial response (pPR). 26 patients (32.5%) showed complete axillary clearance after neoadjuvant chemotherapy. Among them, 5 patients (6.3%) revealed pCR of both the primary tumor and axillary metastasis. SLNB was successful in 61 of 80 patients (76.3%) and there were 3 false negatives, yielding a false negative rate (FNR) of 7.3% (3/41), a negation prediction value (NPV) of 87.0% (20/23), and an accuracy of 95.1% (58/61). Thirteen out of 16 studies retrieved by to MEDLINE pertaining SLNB after neoadjuvant chemotherapy concluded its feasibility and accuracy with a identification rate of 82%-100% and a FNR of 17-100%.

Conclusion

Most studies, including ours, concluded that SLNB after neoadjuvant chemotherapy is accurate and could be an alternative to ALND.

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Abbreviations

ALN:

Axillary lymph node

ALND:

Axillary lymph node dissection

SLN(s):

Sentinel lymph node(s)

SLNB:

Sentinel lymph node biopsy

FNR:

False negative rate

NPV:

Negative prediction value

SUV(s):

Standard uptake value(s)

pCR:

Pathologic complete response

pPR:

Pathologic partial response

pSD:

Pathologic stable disease

IHC:

Immunohistochemical

Rl:

Radioisotope

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Author information

Authors and Affiliations

  1. Research Institute and Hospital, National Cancer Center, Korea

    Seok Hyung Kang, Jae Hee Kang & Eun Sook Lee

  2. Department of Surgery, Dongguk University College of Medicine, Korea

    Eun A Choi

  3. Center for Breast Cancer, National Cancer Center, Madu-1-dong 809, Ilsan-gu, Goyang-si, 411-769, Gyeonggi-do, Korea

    Eun Sook Lee

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  1. Seok Hyung Kang
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  2. Jae Hee Kang
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Correspondence to Eun Sook Lee.

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Kang, S.H., Kang, J.H., Choi, E.A. et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy. Breast Cancer 11, 233–241 (2004). https://doi.org/10.1007/BF02984543

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