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Published in:

01-04-2006

Sentinel Node Biopsy Before Neoadjuvant Chemotherapy Spares Breast Cancer Patients Axillary Lymph Node Dissection

Authors: Maartje C. van Rijk, MD, Omgo E. Nieweg, MD, PhD, Emiel J. T. Rutgers, MD, PhD, FRCS, Hester S. A. Oldenburg, MD, PhD, Renato Valdés Olmos, MD, PhD, Cornelis A. Hoefnagel, MD, PhD, Bin B. R. Kroon, MD, PhD, FRCS

Published in: Annals of Surgical Oncology | Issue 4/2006

Abstract

Background

Neoadjuvant chemotherapy in breast cancer patients is a valuable method to determine the efficacy of chemotherapy and potentially downsize the primary tumor, which facilitates breast-conserving therapy. In 18 studies published about sentinel node biopsy after neoadjuvant chemotherapy, the sentinel node was identified in on average 89%, and the false-negative rate was on average 10%. Because of these mediocre results, no author dares to omit axillary clearance just yet. In our institute, sentinel lymph node biopsy is performed before neoadjuvant chemotherapy. The aim of this study was to evaluate our experience with this approach.

Methods

Sentinel node biopsy was performed before neoadjuvant chemotherapy in 25 T2N0 patients by using lymphoscintigraphy, a gamma ray detection probe, and patent blue dye. Axillary lymph node dissection was performed after chemotherapy if the sentinel node contained metastases.

Results

Ten patients had a tumor-positive axillary sentinel node, and one patient had an involved lateral intramammary node. Four patients had additional involved nodes in the completion lymph node dissection specimen. The other 14 patients (56%) had a tumor-negative sentinel node and did not undergo axillary lymph node dissection. No recurrences have been observed after a median follow-up of 18 months.

Conclusions

Fourteen (56%) of the 25 patients were spared axillary lymph node dissection when the sentinel node was found to be disease free. Performing sentinel node biopsy before neoadjuvant chemotherapy seems successful and reliable in patients with T2N0 breast cancer.

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Title: Sentinel Node Biopsy Before Neoadjuvant Chemotherapy Spares Breast Cancer Patients Axillary Lymph Node Dissection
Authors: Maartje C. van Rijk, MD
Omgo E. Nieweg, MD, PhD
Emiel J. T. Rutgers, MD, PhD, FRCS
Hester S. A. Oldenburg, MD, PhD
Renato Valdés Olmos, MD, PhD
Cornelis A. Hoefnagel, MD, PhD
Bin B. R. Kroon, MD, PhD, FRCS
Publication date: 01-04-2006
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 4/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/ASO.2006.07.025

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sentinel Node Biopsy Before Neoadjuvant Chemotherapy Spares Breast Cancer Patients Axillary Lymph Node Dissection

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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