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KMID : 1134120070100040254
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Journal of Breast Cancer
2007 Volume.10 No. 4 p.254 ~ p.257
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Sentinel Lymph Node Biopsy in Patients with Clinically Nrgative Lymph Node After Neoadjuvant Chemotherapy
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Park Sung-Jin
Lee Woo-Yong
Yang Keun-Ho
Han Se-Hwan
Park Kyeong-Mee
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Abstract
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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 axil lary 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.
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KEYWORD
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Breast cancer, Neoadjuvant chemotherapy, Sentinel lymph node
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