Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy for Breast Cancer

The local management of early-stage breast cancer continues to evolve toward replacing axillary lymph-node dissection (ALND) with sentinel lymph-node biopsy (SLNB) as a standard of care for most women. Long-term follow-up of patients with clinically negative axillary nodes has shown that SLNB provides equivalent prognostic information compared with ALND and results in an equivalent overall clinical outcome and a lower rate of lymphedema (Lancet Oncol 2007; 8:881). Questions that arise from these findings include whether an axillary dissection is required when SLNB is positive for cancer and whether SLNB can be done reliably, safely, and without need for a completion axillary dissection after neoadjuvant chemotherapy in women with axillary n…