Sentinel Lymph Node Surgery After Neoadjuvant Chemotherapy is Accurate and Reduces the Need for Axillary Dissection in Breast Cancer Patients

• DOI: 10.1097/sla.0b013e3181b8fd5e
• Publication Date: 2009-09-24T07:30:30Z
• Authors: Kelly K. Hunt; Min Yi; Elizabeth A. Mitt...; Cynthia Guerrero; Gildy V. Babiera; Isabelle Bedrosian; Rosa F. Hwang; Henry M. Kuerer; Merrick I. Ross; Funda Meric-Bernstam
• Keywords: Axillary Dissection; Neoadjuvant Therapy; Axilla

Sentinel lymph node (SLN) surgery is widely used for nodal staging in early-stage breast cancer. This study was performed to evaluate the accuracy of SLN patients undergoing neoadjuvant chemotherapy versus first.Controversy exists regarding timing planned chemotherapy. Proponents after prefer a single surgical procedure with potential fewer axillary dissections. Opponents cite early studies low identification rates and high false-negative chemotherapy.A total 3746 clinically negative T1-T3 cancer underwent from 1994 2007. Clinicopathologic data were reviewed comparisons made between receiving those first.Of patients, 575 (15.3%) 3171 (84.7%) first. Neoadjuvant younger (51 vs. 57 years, P < 0.0001) had more clinical T2-T3 tumors (87.3% 18.8%, at diagnosis. 97.4% group 98.7% first (P = 0.017). False-negative similar groups (5/84 [5.9%] 22/542 [4.1%] group, 0.39). Analyzed by presenting T stage, there positive SLNs (T1: 12.7% 19.0%, 0.2; T2: 20.5% 36.5%, 0.0001; T3: 30.4% 51.4%, 0.04). Adjusting stage revealed no differences local-regional recurrences, disease-free or overall survival groups.SLN as accurate prior results decreases unnecessary