Sentinel Lymph Node Biopsy in Patients with Clinically Negative Lymph Node After Neoadjuvant Chemotherapy.
10.4048/jbc.2007.10.4.254
- Author:
Sung Jin PARK
1
;
Woo Yong LEE
;
Geun Ho YANG
;
Kyeongmee PARK
;
Sehwan HAN
Author Information
1. Department of Surgery, Inje University Sanggyepaik Hospital, Seoul, Korea. hanse@sanggyepaik.ac.kr
- Publication Type:Original Article
- Keywords:
Breast cancer;
Neoadjuvant chemotherapy;
Sentinel lymph node
- MeSH:
Breast Neoplasms;
Cyclophosphamide;
Doxorubicin;
Drug Therapy*;
Epirubicin;
Female;
Fluorouracil;
Humans;
Lymph Node Excision;
Lymph Nodes*;
Mastectomy, Segmental;
Neoplasm Metastasis;
Sentinel Lymph Node Biopsy*
- From:Journal of Breast Cancer
2007;10(4):254-257
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We wanted to evaluate the accuracy of sentinel lymph node biopsy (SLNB) in patients with clinically negative lymph node after neoadjuvant chemotherapy. METHODS: Fifty-nine women underwent 4 cycles of neoadjuvant chemotherapy with epirubicin (75 mg/m2) plus docetaxel (75 mg/m2), or with doxorubicin (50 mg/m2), cyclophosphamide (600 mg/m2) and 5-fluorouracil (500 mg/m2) for their primary breast cancer. Their median age was 41 yr (range: 29-62) and all the tumors were larger than 3 cm in maximum diameter. SLNB was performed 3 min after periareolar injection of 1% isosulfan blue dye. All the patients underwent lymph node dissection at the level 1 and 2 axillary areas irrespective of their nodal status. RESULTS: A clinical response after neoadjuvant chemotherapy was observed in 46 patients (88%) and 11 (18.7%) patients had a complete pathologic response. Thirty-five patients (62.7%) underwent breast conserving surgery. The sentinel lymph node was identified in 96.6% and the median number of sentinel nodes was 3 (range: 1-6). The median number of dissected nodes was 14 (range: 11-47). Metastasis to the lymph node was observed in 56% of the patients. The sentinel lymph node was the only metastatic node in 12 patients. Three patients with a negative sentinel lymph node were confirmed to have metastasis to non-sentinel nodes after the final histologic examination (false negative rate: 9.1%). The overall accuracy of SLNB was 94.7%. CONCLUSION: SLNB after neoadjuvant chemotherapy was a safe method in patients with clinically negative lymph node.
