The importance of sentinel lymph node biopsy following neoadjuvant chemotherapy in patients with breast cancer: prospective multicentre trial

Česká verzia

Authors: J. Žatecký ^1,2,3 ; O. Kubala ^1,4; O. Coufal ^2,5 ; M. Kepičová ⁴; J. Gatěk ⁶ ; J. Prokop ^1,4; M. Lerch ³; M. Peteja ^1,3
Authors place of work: Katedra chirurgických oborů, Lékařská fakulta, Ostravská univerzita, Ostrava ¹; Klinika operační onkologie, Masarykův onkologický ústav, Brno ²; Chirurgické oddělení, Slezská nemocnice v Opavě, p. o., Opava ³; Chirurgická klinika, Fakultní nemocnice Ostrava, Ostrava ⁴; Klinika operační onkologie, Lékařská fakulta, Masarykova univerzita, Brno ⁵; Chirurgické oddělení, EUC Klinika Zlín, Zlín ⁶
Published in the journal: Rozhl. Chir., 2021, roč. 100, č. 6, s. 271-276.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2021.100.6.271–277

Summary

Introduction: The role of sentinel lymph node biopsy (SLNB) in patients with breast cancer after neoadjuvant chemotherapy (NAC) is currently under discussion. The aim of our study was to determine the false negativity rate (FNR) of SLNB, the accuracy of ultrasound examination in the evaluation of the status of lymph nodes and the accuracy of perioperative cryobiopsy of the sentinel lymph node (SLN).

Methods: Prospective multicentre study, which took place in years 2018−2020 at three centres in the Czech Republic. A total of 59 patients were evaluated.

Results: The FNR of SLNB in the group of patients with cN1 before NAC and ycN0 after NAC was 12.5%. The FNR of perioperative histological examination of the SLN was 38.5%. The FNR of ultrasound examination of axillary lymph nodes in patients after NAC was 35.5%, and the false positivity rate was 16.7%. The incidence of inflammatory complications in our cohort was 3.3%.

Conclusion: The FNR of SLNB in the group of patients with cN1 before NAC and ycN0 after NAC exceeds the tolerable limit of 10%. The FNR of perioperative histological examination of the SLN is high; definitive histological examination of the SLN may change the original diagnostic-therapeutic plan. Ultrasound examination of the axillary lymph nodes in patients after NAC is a method with high false negativity and positivity and may not correspond with the perioperative finding. The incidence of inflammatory complications in our cohort in patients after NAC is comparable to literature data on the frequency of complications in patients without NAC.

Keywords:

breast cancer − sentinel lymph node biopsy − neoadjuvant chemotherapy − axillary dissection

Zdroje

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