Sentinel lymph node biopsy after neoadjuvant chemotherapy for axillary lymph node-positive breast cancer / 中华普通外科杂志

ABSTRACT

Objective To investigate the feasibility and clinical significance of sentinel lymph node biopsy(SLNB) after neoadjuvant chemotherapy (NAC) for axillary lymph node-positive breast cancer.Methods Enrolled for a prospective cohort study were 167 patients from Jan 2016 to Jan 2018 with axillary lymph node-positive breast cancer admitted to the Cancer Hospital of Chinese Academy of Medical Sciences.SLNB was performed after NAC by lymphatic dual mapping,followed by axillary lymph node dissection.The primary end point was sentinel lymph node identification rate (IR) and false negative rate (FNR).Results 62 patients (37.1％) had complete pathological response of axillary lymph nodes.There was a significant difference of NAC response in patients with different subtypes (P ＜0.001).The IR of SLNB after NAC was 94.6％,the FNR was 6.7％,the sensitivity was 93.3％,the specificity was 100％,and the accuracy was 95.8％.Univariate analysis showed that there was no significant difference between tumor stage,hormone receptor status,HER2 expression,and pathological remission in SLN detection group and the SLN undetected group (P ＞ 0.05).The proportion of patients who received breast conserving surgery in the undetected group was significantly higher than that in the test group (P =0.006).Conclusions Sentinel lymph node biopsy after breast neoadjuvant chemotherapy by lymphatic dual mapping is highly accurate with a high identification rate and a low false negative rate.