Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy For Breast Cancer Patients

Objective: To study sentinel lymph node biopsy in the two groups of breast cancer patients, which had neoadjuvant chemotherapy or not before the operation, determining the feasibility of the isotopic sentinel lymph node biopsy in breast cancer patients treated with neoadjuvant chemotherapy.Methods: From April 2006 to March 2009, 99 breast cancer patients were included in our single institution trial. In group A, 60 patients with T1～2N0M0 directly treated with sentinel lymph node biopsy. In group B: 39 patients with T2～3N0M0 received 3～4 cycles neoadjuvant chemotherapy until they becoming T1～2N0M0, then treated with sentinel lymph node biopsy. All of the patients received a subareolar injection of 99mTechnetium labeled unfiltered sulfur colloid. Detect the sentinel lymph node by using a gamma probe during the operations. Then axillary lymph node dissections were performed with level I and level II. All of the sentinel lymph nodes and axillary lymph nodes were sent for hematoxylin and eosin staining pathologic examination.Results: In group A, the successful identification rate, false negative rate, sensitivity, specificity, accuracy, positive predictive value and negative predictive value was 98.3%(59/60),3.3%(1/30),96.7%(29/30),100%(29/29),98.3%(58/59),100%(28/28) and 96.7%(29/30),respectively. In group B, it was 100%(39/39),10%(2/20),90%(18/20),100%(19/19),94.9%(37/39),100%(18/18)and 90.5%(19/21),respectively. The false negative rate, accuracy have no significant differences between the two groups. (P>0.05)Conclusion: This trial confirmed the feasibility of isotopic sentinel lymph node biopsy after neoadjuvant chemotherapy in the local advanced breast cancer patients. The false negative rate and accuracy did not differ from those obtained in the case of early breast cancer.