Sentinel lymph node biopsy for breast cancer after neoadjuvant chemotherapy: influence of nodal status before treatment

Guillaume Le Bouëdec; Benjamin Geissler; Pierre Gimbergues; Florent Cachin; Frédérique Penault-Llorca; Fabrice Kwiatkowski; Jacques Dauplat; Jean Maublant



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Sentinel lymph node biopsy for breast cancer after neoadjuvant chemotherapy: influence of nodal status before treatment
Bulletin du Cancer. Volume 93, Number 4, 415-9, Avril 2006, Article original
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Author(s) : Guillaume Le Bouëdec, Benjamin Geissler, Pierre Gimbergues, Florent Cachin, Frédérique Penault-Llorca, Fabrice Kwiatkowski, Jacques Dauplat, Jean Maublant
Summary : Objectives: To determine feasibility and accuracy of SLN biopsy in locally advanced breast cancer treated by neoadjuvant chemotherapy. Materials and methods: From April 2001 to December 2004, a prospective series was constituted of 74 women with invasive breast carcinoma T1T2T3N0N1 receiving neoadjuvant chemotherapy. The SLN located was removed using subdermal periareolar injection of radiolabelled nanocolloid and axillary lymph node dissection was systematically performed. Results: A SLN was identified in 68/74 (92%) patients. It was metastatic in 30/68 cases (44%). The false negative (FN) rate was 14% (5/35). In the subgroup of 42 patients clinically N ₀ before chemotherapy, accuracy was 100 %, and FN rate 0%, in the 32 N1, accuracy was 83%, and FN rate 25%. Conclusions: SLN biopsy using a single subdermal injection of radiolabelled nanocolloid in patients with a breast cancer treated by neoadjuvant chemotherapy is technically feasible and appears to be highly accurate in the subgroup of patients with a clinically negative axilla breast cancer before treatment.
Keywords : breast cancer, neoadjuvant chemotherapy, sentinel lymph node