Clinical Significance of Axillary Sentinel Lymph Node Biopsy in Breast Cancer Patients After Neoadjuvant Chemotherapy

Abstract

Objective To investigate the feasibility, accuracy and clinical significance of sentinel lymph node biopsy (SLNB) for breast cancer patients after neoadjuvant chemotherapy. Methods From June 2010 to June 2012, forty-two breast cancer patients (staging ⅡB were 28 cases, staging ⅢA were 10 cases, staging ⅢB were 4 cases) underwent SLNB by using methylene blue dye as tracer and axillary lymph node dissection (ALND) were retrospectively reviewed. Patients of staging ⅡB and Ⅲ underwent SLNB and ALND after 4-6 circles neoadjuvant chemotherapy. The SLN and ALN specimens were carried out histopathological examination with H&E and immunohistochemstry. Results The SLN successful identification rate, false negative rate, sensitivity, accuracy, and negative predictive value was 88.1%, 13.3%, 80.0%, 94.6%, 92.6%, respectively, in breast cancer patients with neoadjuvant chemotherapy. In addition, there had significant differences between SLN identification rate after neoadjuvant chemotherapy and tumour diameter (≤5 cm and >5 cm), BMI (<25 kg/m2 and ≥25 kg/m2), and clinical N stage (N2 stage and N0-1 stage) before neoadjuvant chemotherapy (P<0.05). Conclusions The SLNB can accurately predict lymph node status of axillary lymph node in patients with neoadjuvant chemotherapy. Clinical N stage, BMI and tumour diameter are predictors to the identification rate of SLND in the breast cancer patents. Key words: breast cancer; sentinel lymph node; neoadjuvant chemotherapy