Agnė Čižauskaitė, Donatas Petrauskas, Dainius Šimčikas, Alvydas Česas
Objective. To evaluate the predictable percentage of patients that could be eligible for sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in Klaipeda University Hospital Breast Surgery Department. Background. Although SLNB is a standard staging method for axillar node status assessment for early- stage clinically lymph node (LN) negative breast cancer patients, SLNB after NAC is still controversial. Axillary lymph node dissection (ALND) still remains standard accepted surgical approach for patients following NAC regardless of primary LN status. ALND is associated with significant morbidity and complications. NAC is now used with increasing frequency not only for locally advanced but also for early-stage breast cancer and optimal indications for SLNB after NAC are required. Methods. 163 cases with breast cancer treated by NAC were enrolled in this study. After NAC all patients at the time of definitive breast surgery, underwent ALND. Results. Before NAC, clinical LN status was negative in 21 cases (13%) and positive in 141 (87%). When evaluated postoperatively, pN0 in clinically LN negative group was detected in 21 patients (100%). Meanwhile in clinically LN positive group, pN0 was 63 (44.7%) and pN+ 78 (55.3%) of cases. Conclusions. SLNB should always be performed before or after NAC in clinically LN negative patients. Optimal technique should be chosen in node- positive patients to assure the success of the procedure.
Keyword(s): breast cancer; sentinel lymph node; neoadjuvant chemotherapy; axillar lymph node dissection.
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