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Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in Patients with Cytologically Proven Node-positive Breast Cancer at Diagnosis

Authors
 Seho Park  ;  Ji Min Park  ;  Jung Hoon Cho  ;  Hyung Seok Park  ;  Seung Il Kim  ;  Byeong-Woo Park 
Citation
 Annals of Surgical Oncology, Vol.20(9) : 2858-2865, 2013 
Journal Title
 Annals of Surgical Oncology 
ISSN
 1068-9265 
Issue Date
2013
Abstract
Background The performance of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NCT) was investigated in patients with locally advanced breast cancer (LABC). Methods After NCT of 178 patients with cytology-proven axillary/supraclavicular nodes metastasis at the time of diagnosis, SLNB using radioisotope was performed including completion node dissection between 2008 and 2011. The detection rate, sensitivity, false negative rate (FNR), negative predictive value (NPV) and accuracy of SLNB were analyzed. Results SLNB was successfully performed in 169 (94.9 %) patients. Tumor nonresponse and extensive residual nodal disease were found to be significantly associated with detection failure of sentinel nodes. Sensitivity, FNR, NPV, and accuracy of SLNB were 78.0, 22.0, 75.8, and 87.0 %, respectively, and a greater number of retrieved SLNs increased all four of these performance measures. Conversion to node-negative disease was achieved in 69 (40.8 %) patients: 24 % of patients with the luminal A subtype, 51.6 % of patients with the luminal B, 51.7 % of patients with the HER2-enriched, and 58.5 % of patients with the triple-negative breast cancer (TNBC) subtype. Luminal B, HER2-enriched, and TNBC subtypes showed comparable responses to NCT; however, the TNBC subtype had a significantly better FNR and accuracy. Conclusions SLNB was found to be technically feasible, but its routine use was not recommended for LABCs after NCT. However, acceptable performance was noted for locally advanced TNBCs, and thus SLNB might be safely considered in these selected patients.
Full Text
http://link.springer.com/article/10.1245/s10434-013-2992-8
DOI
10.1245/s10434-013-2992-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김승일(Kim, Seung Il)
박병우(Park, Byeong Woo) ORCID logo https://orcid.org/0000-0003-1353-2607
박세호(Park, Se Ho) ORCID logo https://orcid.org/0000-0001-8089-2755
박지민(Park, Ji Min)
박형석(Park, Hyung Seok) ORCID logo https://orcid.org/0000-0001-5322-6036
조정훈(Cho, Jung Hoon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87398
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