TITLE:
Sentinel Lymph Node Biopsy Prior to Neoadjuvant Chemotherapy: A Series of 89 Patients
AUTHORS:
Flipo Bernard, Clough Krishna, Nos Claude, Miramand Bernard, Michel Cecile, Houvenaeghel Gilles, Meurette Jacques, Alfonsi Jean-Pierre
KEYWORDS:
Breast Cancer; Neoadjuvant Therapy; Clinical Trial; Sentinel Lymph Node Biopsy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.3 No.6,
December
6,
2012
ABSTRACT: Purpose: There are still un-responded questions concerning the type of and the timing of axillary procedures that has to be performed in association with neoadjuvant chemotherapy. Methods: We led a prospective, multicentric, non-randomized study to evaluate the feasibility and accuracy of sentinel lymph node biopsy before neoadjuvant chemotherapy. The clinical and radiological response to chemotherapy was evaluated after 4 treatment cycles and at the end of chemotherapy. Axillary lymph node dissection was performed 3 to 4 weeks after chemotherapy. Histological analysis of sentinel lymph node biopsies and axillary lymph node dissections were studied for each patient. Results: Eighty nine patients had sentinel lymph node biopsy. The identification rate for sentinel lymph nodes was 98.9%. The sentinel lymph node biopsies were metastatic in 44 of 88 patients. Axillary lymph nodes were metastatic in 12 cases. The negative predictive value was 91.1% [95%CI: 85.1% - 97.1%]. Conclusion: Identification rate and negative predictive value of sentinel lymph node biopsy prior to neoadjuvant chemotherapy confirm that the procedure is suitable with its use in standard practice. This approach comprises two surgical procedures, but allows a better nodal status evaluation.