The success of sentinel lymph node biopsy after neoadjuvant therapy: A single institution review

James M. Chang, Heidi E. Kosiorek, Nabil Wasif, Richard J. Gray, Chee Chee H. Stucky, Donald W. Northfelt, Karen Anderson, Ann E. McCullough, Idris Tolgay Ocal, Barbara A. Pockaj

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: The appropriate management of the axilla among women undergoing neoadjuvant therapy is in evolution. Method: A retrospective review of a prospective database of women with breast cancer who underwent neoadjuvant systemic therapy using endocrine/chemotherapy (NE/CT) from 2002 to 2015 was performed. Results: We reviewed 253 women: triple negative breast cancer (30%), ER+HER2- (44%) breast cancer and HER2+ (25%) disease. The mean age was 55 years (SD = 12). 197 patients were analyzed based on their axillary disease. 33 patients (35%) who had clinical N1-3 disease prior to neoadjuvant therapy had no axillary metastases at definitive surgery. There were no significant differences in overall survival or local/regional recurrence between patients who underwent axillary lymph node dissection (ALND), sentinel lymph node biopsy (SLNB), or SLNB+ALND (p = 0.05061 and p = 0.33). Conclusion: SLNB is a viable technique in patients with breast cancer undergoing NE/CT. Patients with pre-neoadjuvant therapy proven axillary disease may be a candidate for SLNB as opposed to planned ALND with good multidisciplinary review of their response and localization of previously positive lymph nodes.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - 2017
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Chang, J. M., Kosiorek, H. E., Wasif, N., Gray, R. J., Stucky, C. C. H., Northfelt, D. W., Anderson, K., McCullough, A. E., Ocal, I. T., & Pockaj, B. A. (Accepted/In press). The success of sentinel lymph node biopsy after neoadjuvant therapy: A single institution review. American Journal of Surgery. https://doi.org/10.1016/j.amjsurg.2017.08.024