D Carrera1, M de la Flor2, J Galera3, K Amillano4, M Gomez3, V Izquierdo1, E Aguilar5, S López6, M Martínez7, S Martínez8, J M Serra9, M Pérez10, L Martin11. 1. Servicio de Medicina Nuclear, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España. 2. Servicio de Ginecología y Obstetricia, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España. Electronic address: miriamjose.delaflor@urv.cat. 3. Servicio de Ginecología y Obstetricia, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España. 4. Servicio de Oncología, Hospital Universitario de Sant Joan de Reus, Esplugues de Llobregat, Barcelona, España. 5. Servicio de Ginecología y Obstetricia, Hospital Universitario de Sant Joan de Reus, Esplugues de Llobregat, Barcelona, España. 6. Servicio de Cirugía, Hospital Sant Pau y Santa Tecla, Tarragona, España. 7. Servicio de Cirugía, Hospital del Vendrell, El Vendrell, Tarragona, España. 8. Servicio de Anatomía Patológica, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España. 9. Servicio de Cirugía Plástica, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. 10. Unidad Funcional Interdisciplinar Sociosanitaria cuidados Paliativos, Hospital Universitario de Tarragona Joan XXIII-Gestió i Prestació de Serveis de Salut, Tarragona, España. 11. Servicio de Radiodiagnóstico, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España.
Abstract
INTRODUCTION: The aim of our study was to evaluate sentinel lymph node biopsy as a diagnostic test for assessing the presence of residual metastatic axillary lymph nodes after neoadjuvant chemotherapy, replacing the need for a lymphadenectomy in negative selective lymph node biopsy patients. MATERIAL AND METHODS: A multicentre, diagnostic validation study was conducted in the province of Tarragona, on women with T1-T3, N1-N2 breast cancer, who presented with a complete axillary response after neoadjuvant chemotherapy. Study procedures consisted of performing an selective lymph node biopsy followed by lymphadenectomy. RESULTS: A total of 53 women were included in the study. Surgical detection rate was 90.5% (no sentinel node found in 5 patients). Histopathological analysis of the lymphadenectomy showed complete disease regression of axillary nodes in 35.4% (17/48) of the patients, and residual axillary node involvement in 64.6% (31/48) of them. In lymphadenectomy positive patients, 28 had a positive selective lymph node biopsy (true positive), while 3 had a negative selective lymph node biopsy (false negative). Of the 28 true selective lymph node biopsy positives, the sentinel node was the only positive node in 10 cases. All lymphadenectomy negative cases were selective lymph node biopsy negative. These data yield a sensitivity of 93.5%, a false negative rate of 9.7%, and a global test efficiency of 93.7%. CONCLUSIONS: Selective lymph node biopsy after chemotherapy in patients with a complete axillary response provides valid and reliable information regarding axillary status after neoadjuvant treatment, and might prevent lymphadenectomy in cases with negative selective lymph node biopsy.
INTRODUCTION: The aim of our study was to evaluate sentinel lymph node biopsy as a diagnostic test for assessing the presence of residual metastatic axillary lymph nodes after neoadjuvant chemotherapy, replacing the need for a lymphadenectomy in negative selective lymph node biopsy patients. MATERIAL AND METHODS: A multicentre, diagnostic validation study was conducted in the province of Tarragona, on women with T1-T3, N1-N2 breast cancer, who presented with a complete axillary response after neoadjuvant chemotherapy. Study procedures consisted of performing an selective lymph node biopsy followed by lymphadenectomy. RESULTS: A total of 53 women were included in the study. Surgical detection rate was 90.5% (no sentinel node found in 5 patients). Histopathological analysis of the lymphadenectomy showed complete disease regression of axillary nodes in 35.4% (17/48) of the patients, and residual axillary node involvement in 64.6% (31/48) of them. In lymphadenectomy positive patients, 28 had a positive selective lymph node biopsy (true positive), while 3 had a negative selective lymph node biopsy (false negative). Of the 28 true selective lymph node biopsy positives, the sentinel node was the only positive node in 10 cases. All lymphadenectomy negative cases were selective lymph node biopsy negative. These data yield a sensitivity of 93.5%, a false negative rate of 9.7%, and a global test efficiency of 93.7%. CONCLUSIONS: Selective lymph node biopsy after chemotherapy in patients with a complete axillary response provides valid and reliable information regarding axillary status after neoadjuvant treatment, and might prevent lymphadenectomy in cases with negative selective lymph node biopsy.
Authors: Juan C Vázquez; Antonio Piñero; Francisco J de Castro; Ana Lluch; Miguel Martín; Agustí Barnadas; Emilio Alba; Álvaro Rodríguez-Lescure; Federico Rojo; Julia Giménez; Ivan Solá; Maria J Quintana; Xavier Bonfill; Gerard Urrutia; Pedro Sánchez-Rovira Journal: Clin Transl Oncol Date: 2022-09-25 Impact factor: 3.340
Authors: Janine M Simons; Thiemo J A van Nijnatten; Carmen C van der Pol; Ernest J T Luiten; Linetta B Koppert; Marjolein L Smidt Journal: Ann Surg Date: 2019-03 Impact factor: 12.969