Prospective Evaluation of the Feasibility of Sentinel Lymph Node Biopsy in Breast Cancer Patients with Negative Axillary Conversion after Neoadjuvant Chemotherapy

이해디; 안성귀; 이승아; 이학민; Joon Jeong

Prospective Evaluation of the Feasibility of Sentinel Lymph Node Biopsy in Breast Cancer Patients with Negative Axillary Conversion after Neoadjuvant Chemotherapy

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Type: Academic journal

Author: 이해디 안성귀 이승아 이학민 Joon Jeong

Journal: 대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제47권 제1호 KCI Accredited Journals

Published: 2015.1

Pages: 26 - 33 (8page)

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Prospective Evaluation of the Feasibility of Sentinel Lymph Node Biopsy in Breast Cancer Patients with Negative Axillary Conversion after Neoadjuvant Chemotherapy

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Purpose Tumor response to neoadjuvant chemotherapy (NAC) may adversely affect the identificationand accuracy rate of sentinel lymph node biopsy (SLNB). This study was conducted toevaluate the feasibility of SLNB in node-positive breast cancer patients with negative axillaryconversion after NAC. Materials and MethodsNinety-six patients with positive nodes at presentation were prospectively enrolled. 18Fluorodeoxyglucose-positron emission tomography (18F-FDG PET) and ultrasonographywere performed before and after NAC. A metastatic axillary lymph node was defined aspositive if it was positive upon both 18F-FDG PET and ultrasonography, while it was considerednegative if it was negative upon both 18F-FDG PET and ultrasonography. ResultsAfter NAC, 55 cases (57.3%) became clinically node-negative, while 41 cases (42.7%)remained node-positive. In the entire cohort, the sentinel lymph node (SLN) identificationand false-negative rates were 84.3% (81/96) and 18.4% (9/49), respectively. In thenegative axillary conversion group, the results of SLNB showed an 85.7% (48/55) identificationrate and 16.7% (4/24) false-negative rate. ConclusionFor breast cancer patients with clinically positive nodes at presentation, it is difficult toconclude whether the SLN accurately represents the metastatic status of all axillary lymphnodes, even after clinically negative node conversion following NAC.

#Breast neoplasms #Neoadjuvant therapy #Sentinel lymph node biopsy #Predictive value of tests

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Boughey JC / 2013 / Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer : the ACOSOG Z1071(Alliance)clinical trial / JAMA

Buchholz TA / 2008 / Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer : a National Cancer Institute conference /

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