ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer with initially cytologically confirmed negative axillary lymph nodes. A review

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ABSTRACT

Introduction. Performing the sentinel lymph node (SLN) biopsy remains the gold standard method to stage the axilla in breast cancer (BC) patients. For women with breast tumors who have an indication for neoadjuvant chemotherapy (NAC) (either locally advanced BC or early-stage BC with unfavorable prognos- tic factors- Her-2/ neu positive or triple negative BC) and without initial involvement of the lymph nodes (LNs), the SLN biopsy is generally applied before the NAC. However, many studies as well as the data presented at the San Antonio Breast Cancer Symposium 2016 demonstrated that SLN after NAC in women with initially negative nodes is safe with a low rate of recurrence.

The objective of this review is to present the argument for performing the SLN excision after NAC in women with initially clinically negative LNs before.

Method. We performed a research on Pubmed for studies which included the evaluation of the SLNs after NAC and focused our paper on the identification rate (IR) of the sentinel LNs, false-negative rate (FNR) of the status of the sentinel LNs as well as the recurrence rate of the disease when SLB has been performed after NACT. The used key words were: „breast cancer“, „neoadjuvant chemotherapy“, „sentinel lymph node“ and „pathologic complete response“.

Conclusion. The reported IR and FNR of the SLN concept performed after NAC as well as the disease-free and overall survival rate observed after a period of follow-up are arguments to support the idea the SLN biopsy can be safely performed after the completion of the NAC in a single procedure together with the breast operation, with the essential condition that the axillary LNs are (cytologically confirmed) negative at the initial examination prior to pursue to the initiation of the NAC.

Keywords: breast cancer, sentinel lymph node, neoadjuvant chemotherapy.

Corresponding author:

Nicolae BACALBASA
Dimitrie Racoviță Street, no. 2, Bucharest, Romania
E-mail: nicolae_bacalbasa@yahoo.ro
Phone no: +40723540426

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