BACKGROUND: The aim was to prove the low identification rate of sentinel lymph node biopsy (SNB) and to determine the feasibility of replacing axillary lymph node dissection (AND) in axillary lymph node positive patients after chemotherapy. METHODS: From October 2001 to July 2005, 875 consecutive patients with primary operable breast cancer underwent SNB and AND. Among them, 238 received pre-operative chemotherapy. We compared the identification rate, false negative rate (FNR), negative predictive value (NPV), and accuracy of SNB in clinically node-positive patients with or without chemotherapy. RESULTS: The identification rate was significantly lower in patients received chemotherapy (77.6%) than in those not received it (97.0%) (P<0.001). In those received the therapy, the FNR was 5.6%, the NPV was 86.8%, and the accuracy was 95.9%. In those not received therapy, the FNR was 7.4% and the accuracy was 92.6% (differences not statistically significant). CONCLUSION: The identification rate in confirmed axillary lymph node-positive patients was significantly lower in patients received pre-operative chemotherapy, but accuracy did not differ significantly between the two groups. Thus, for patients who achieve complete axillary clearance by chemotherapy, SNB could replace AND.
BACKGROUND: The aim was to prove the low identification rate of sentinel lymph node biopsy (SNB) and to determine the feasibility of replacing axillary lymph node dissection (AND) in axillary lymph node positive patients after chemotherapy. METHODS: From October 2001 to July 2005, 875 consecutive patients with primary operable breast cancer underwent SNB and AND. Among them, 238 received pre-operative chemotherapy. We compared the identification rate, false negative rate (FNR), negative predictive value (NPV), and accuracy of SNB in clinically node-positive patients with or without chemotherapy. RESULTS: The identification rate was significantly lower in patients received chemotherapy (77.6%) than in those not received it (97.0%) (P<0.001). In those received the therapy, the FNR was 5.6%, the NPV was 86.8%, and the accuracy was 95.9%. In those not received therapy, the FNR was 7.4% and the accuracy was 92.6% (differences not statistically significant). CONCLUSION: The identification rate in confirmed axillary lymph node-positive patients was significantly lower in patients received pre-operative chemotherapy, but accuracy did not differ significantly between the two groups. Thus, for patients who achieve complete axillary clearance by chemotherapy, SNB could replace AND.
Authors: Judy C Boughey; Vera J Suman; Elizabeth A Mittendorf; Gretchen M Ahrendt; Lee G Wilke; Bret Taback; A Marilyn Leitch; Teresa S Flippo-Morton; Henry M Kuerer; Monet Bowling; Kelly K Hunt Journal: Ann Surg Date: 2015-03 Impact factor: 12.969
Authors: Laura S Dominici; Viviana M Negron Gonzalez; Aman U Buzdar; Anthony Lucci; Elizabeth A Mittendorf; Huong T Le-Petross; Gildy V Babiera; Funda Meric-Bernstam; Kelly K Hunt; Henry M Kuerer Journal: Cancer Date: 2010-06-15 Impact factor: 6.860
Authors: Nicole E Sharp; Darren B Sachs; Nicole M Melchior; Philip Albaneze; Salvatore Nardello; Elin R Sigurdson; Mengying Deng; Allison A Aggon; John M Daly; Richard J Bleicher Journal: Breast J Date: 2021-03-11 Impact factor: 2.431
Authors: Sae Byul Lee; Hakyoung Kim; Jisun Kim; Il Yong Chung; Hee Jeong Kim; Beom Seok Ko; Jong Won Lee; Sei Hyun Ahn; Byung Ho Son Journal: PLoS One Date: 2021-05-18 Impact factor: 3.240