Lower nodal counts in axillary dissection following neoadjuvant chemotherapy: are there implications?

Abstract

Traditionally, axillary lymph node dissection (ALND) has been used for staging purposes for locally advanced breast cancer. ALND generally involves taking the level I and II axillary nodes to achieve an adequate dissection. Historically, a minimum of 8 to 10 axillary nodes was required for accurate staging [1–3]. Neuman et al [4] examined the yield of axillary nodes obtained during ALND after neoadjuvant chemotherapy. The authors present a single institutional experience comparing the total lymph node count from ALND performed with or without neoadjuvant chemotherapy. In patients undergoing a level I or II ALND after neoadjuvant therapy, the percentage of individuals with fewer than 10 lymph nodes was higher than ALND alone without neoadjuvant therapy (13% vs. 4%, respectively) [4]. However, there was no difference in median lymph node counts. In addition, no local axillary recurrences were reported over a median follow-up period of 64 months for the 19 patients in the neoadjuvant group with fewer than 10 nodes recovered