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Feasibility, accuracy and prognosis of sentinel lymph node biopsy before neoadjuvant therapy in breast cancer. A prospective study.
- Source :
-
International journal of surgery (London, England) [Int J Surg] 2017 Mar; Vol. 39, pp. 141-147. Date of Electronic Publication: 2017 Jan 30. - Publication Year :
- 2017
-
Abstract
- Background and Objective: It remains controversial whether sentinel lymph node biopsy (SLNB) should be performed before or after neoadjuvant therapy (NAT). We aimed to evaluate the feasibility and accuracy of SLNB before NAT at a single institution, and to determine its relation to patient prognosis.<br />Methods: A prospective study of T1c-T2-T3 N0 breast cancer patients, after ultrasound examination, who underwent SLNB prior to NAT. Overall, disease-specific and disease-free survival were calculated by Kaplan-Meier curves.<br />Results: SLNB before NAT was performed in 123 patients from December 2006 to May 2014. The identification rate was 100%. SLNB was positive in 42.3% of cases (27.6% macrometastases). NAT was chemotherapy in 88.6% of cases and endocrine-therapy in 11.4%. Lymphadenectomy was avoided in 72.4% of cases. Median follow-up was 40 months (range 8-100). Overall and disease-free survival was 90.2% and 88.6% respectively.SLN involvement was not related to patient outcome (p 0.72); however there were significant differences in survival according to molecular-like subtypes (p < 0.025) and NAT response (p < 0.0001).<br />Conclusions: SLNB prior to NAT is an accurate method of axillary staging associated with a high identification rate. It avoided lymphadenectomy in more than 70% of patients. SLN involvement did not worsen the prognosis in our cohort.<br /> (Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Axilla
Breast Neoplasms therapy
Disease-Free Survival
Feasibility Studies
Female
Humans
Kaplan-Meier Estimate
Lymph Node Excision statistics & numerical data
Middle Aged
Neoplasm Staging
Prognosis
Prospective Studies
Breast Neoplasms pathology
Neoadjuvant Therapy methods
Sentinel Lymph Node pathology
Sentinel Lymph Node Biopsy methods
Time Factors
Subjects
Details
- Language :
- English
- ISSN :
- 1743-9159
- Volume :
- 39
- Database :
- MEDLINE
- Journal :
- International journal of surgery (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 28153783
- Full Text :
- https://doi.org/10.1016/j.ijsu.2017.01.106