The significance of axillary sentinel lymph node biopsy after neoadjuvant chemotherapy

Abstract

Objective Comparing the influence of neoadjuvant chemotherapy on sentinel lymph node biopsy and axillary lymph nodal staging. Methods From June 2005 to June 2007 one hundred and sixty five breast cancer patients of stage Ⅰ,Ⅱa,Ⅱb and Ⅲ underwent sentinel lymph node biopsy(SLNB) using 99mTc combining methylene blue dye as tracer to help axillary lymph node dissection(AND) were retrospectively reviewed. Sixty five patients staged Ⅱb or Ⅲ were treated with three circles neoadjuvant chemotherapy prior to SLNB and AND , another one hundred patients staged ⅠorⅡa had SLNB and AND directly without neoadjuvant chemotherapy.Results Average 14.60 axillary lymph nodes were retrieved in patients had neoadjuvant chemotherapy and 14.74 lymph nodes in patients did not have neoadjuvant chemotherapy(P>0.05),a mean number of 1.46 sentinel lymph nodes in neoadjuvant chemotherapy group and 1.5 sentinel lymph nodes in non-neoadjuvant chemotherapy(P>0.05), sentinel lymph node identification rate 96.9% in neoadjuvant chemotherapy group and 97% in non-neoadjuvant chemotherapy(P>0.05), the false negative rate was 4.6% in neoadjuvant chemotherapy group and 4% in non-neoadjuvant chemotherapy group(P>0.05). Conclusions The mean number of lymph nodes,sentinel lymph nodes,SLN identification rate and false-negative rates after neoadjuvant chemotherapy are similar to those seen in patients without neoadjuvant chemotherapy.The SLNB can accurately predict lymph node status of axillary lymph node following neoadjuvant chemotherapy. Key words: Breast cancer; Sentinel lymph node; Neoadjuvant chemotherapy