Sentinel lymph node biopsy after neoadjuvant chemotherapy for axillary lymph node-positive breast cancer
10.3760/cma.j.issn.1007-631X.2019.06.003
- VernacularTitle:腋窝淋巴结阳性乳腺癌新辅助化疗后前哨淋巴结活检的可行性分析
- Author:
Wenyan WANG
1
;
Xiangzhi MENG
;
Jiaqi LIU
;
Jie WANG
;
Zeyu XING
;
Menglu ZHANG
;
Xin WANG
Author Information
1. 首都医科大学附属北京天坛医院乳腺科
- Keywords:
Breast neoplasms;
Chemotherapy,adjuvant;
Sentinel lymph node biopsy;
Molecular subtype
- From:
Chinese Journal of General Surgery
2019;34(6):479-482
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and clinical significance of sentinel lymph node biopsy(SLNB) after neoadjuvant chemotherapy (NAC) for axillary lymph node-positive breast cancer.Methods Enrolled for a prospective cohort study were 167 patients from Jan 2016 to Jan 2018 with axillary lymph node-positive breast cancer admitted to the Cancer Hospital of Chinese Academy of Medical Sciences.SLNB was performed after NAC by lymphatic dual mapping,followed by axillary lymph node dissection.The primary end point was sentinel lymph node identification rate (IR) and false negative rate (FNR).Results 62 patients (37.1％) had complete pathological response of axillary lymph nodes.There was a significant difference of NAC response in patients with different subtypes (P ＜0.001).The IR of SLNB after NAC was 94.6％,the FNR was 6.7％,the sensitivity was 93.3％,the specificity was 100％,and the accuracy was 95.8％.Univariate analysis showed that there was no significant difference between tumor stage,hormone receptor status,HER2 expression,and pathological remission in SLN detection group and the SLN undetected group (P ＞ 0.05).The proportion of patients who received breast conserving surgery in the undetected group was significantly higher than that in the test group (P =0.006).Conclusions Sentinel lymph node biopsy after breast neoadjuvant chemotherapy by lymphatic dual mapping is highly accurate with a high identification rate and a low false negative rate.
