Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy

In patients with biopsy-proven, node-positive breast cancer, the false-negative rate was 8.4% with the use of immunohistochemistry.

Neoadjuvant chemotherapy and biologic agents not only can have dramatic effects on primary breast tumors, but they also can eradicate nodal metastases in 30% to 40% of patients overall and in 74% of patients with HER2-positive disease if given concurrently with trastuzumab (Cancer 2010; 116:2884). An ongoing controversy in this setting is whether sentinel lymph node biopsy (SLNB) can be used in place of complete node dissection (CND) to accurately identify patients who achieve pathologic complete response after neoadjuvant chemotherapy.

To address this issue, investigators conducted a prospective, multicenter study of 153 patients with biopsy-proven, node-positive disease (T0–3, N1–2) who underwent both SLNB and CND. An optimal SLNB false-ne…

Reviewing Author

Henry Mark Kuerer, MD, PhD, FACS

Disclosures

Speaker's BureauPhysicians’ Education Resource, LLC

RoyaltiesMcGraw-Hill Professional; UpToDate, Inc.

Editorial BoardsAnnals of Surgical Oncology

Leadership Positions in Professional SocietiesAmerican Society of Breast Surgeons (Chair, Publications Committee)