This study aimed to evaluate the prognostic effects of sentinel lymph node biopsy (SLNB) on recurrence and survival after neoadjuvant chemotherapy (NAC) in patients with cytology-proven axillary node metastasis breast cancer.
This study is a registered medical record review based on a prospectively collected cohort. We selected 506 patients who were diagnosed with invasive breast cancer and axillary lymph nodes metastasis and treated with NAC followed by curative surgery at Samsung Medical Center between January 2007 and December 2014. We classified patients into three groups: Group A, negative SLN status and no further dissection; Group B, negative SLN status with backup axillary lymph node dissection (ALND); and Group C, no residual axillary metastasis on pathology with ALND regardless of clinical response. We analyzed and compared outcomes including prognoses and survival among all groups.
The median age at the time of surgery was 44.4 years. The median follow-up time was 47.0 months (range: 3-115 months) and the median number of retrieved SLNs was 5.0. The SLN identification rate was 98.3% (234/238 patients), and the false negative rate (FNR) of SLNB after NAC was 7.5% (8/106 patients). There was no significant difference in disease-free survival (DFS, p = 0.578) or overall survival (OS, p = 0.149) among Groups A, B, and C.
These results suggest that SLNB can be feasible and oncologically safe after NAC for node-positive breast cancer and could help reduce arm morbidity by avoiding standard ALND in negative SLN patients.
Clinical trial identification
Legal entity responsible for the study
Samsung Medical Center.
Has not received any funding.
All authors have declared no conflicts of interest.