The feasibility of sentinel lymph node (SLN) biopsy examination after neoadjuvant chemotherapy for breast cancer patients

Abstract

Introduction. The feasibility of sentinel lymph node biopsy examination for breast cancer patients that had no clinically detected lymph nodes and underwent neoadjuvant chemotherapy have been analyzed by injecting blue dye into the area near the tumor. Aim of the study. Axillary status is one of the most important prognostic factors for breast cancer. Sentinel node biopsy has become a standard procedure for axillary staging in clinically node-negative patients. This technique brings out important information that helps physician in therapeutic management of these patients. Lymphadenectomy is an invasive procedure associated with higher morbidity and complications that has shown to be unnecessary in some cases of breast cancer. Materials and methods.. Forty patients with stages 0-II breast cancer treated with neoadjuvant chemotherapy were enrolled in the study. The sentinel node biopsy was performed after blue dye injection into the tumor. Sentinel nodes stained bright blue and were removed. The sentinel nodes have been examined under the microscope for cancer signs. Depending on the biopsy results this was followed or not by lymphadenectomy . Parameters like age, size of tumor, Nottingham grade, presence of hormonal receptors, HER 2 enriche, presence of microcalcification, necrosis and inflammatory infiltrate have been studied to predict the risk of axillary metastasis. Results. Forty patients received SLN biopsy after neoadjuvant chemotherapy. Ten cases (25%) of these had positive sentinel lymph nodes confirmed by anatomopathological examination. Lymphadenectomy procedure have been performed and only 3 of them (30%) had metastatic lymph nodes in the rest of the axilla. Conclusions. SLN biopsy accuracy after neoadjuvant chemotherapy is still debated in literature. Thirty of our patients were saved form an unnecessary axillary lymph node dissection by using SLN biopsy technique.