Sentinel node biopsy in breast cancer patients undergoing induction chemotherapy should be performed prior to chemotherapy

Abstract

Presently, preoperative chemotherapy is administered ever more frequently in breast cancer patients. It is administered in both non-resectable and resectable patients, i.e. those in whose case it is possible to undertake surgical treatment without the use of chemotherapy. Sentinel node biopsy may only be performed in patients classified as cN0. Hence, the dilemma of whether sentinel node biopsy should be performed before or after preoperative chemotherapy applies only to those patients in whom there are no axillary lymph node metastases before the chemotherapy in question (cN0). Even though the question of whether to perform sentinel node biopsy before or after preoperative chemotherapy in cN0 patients still remains open, a number of indicators testifying to the quality of the results obta­ined, tend to point in favour of sentinel node biopsy performed prior to chemotherapy. When sentinel node biopsy is performed before induction chemotherapy, the node identification rate is higher (100% vs 95%), and the rate of false negative results is lower (7.4% vs 11.4%) than in the case of a post-chemotherapy biopsy.