Evaluation of Sentinel Lymph Node Biopsy After Primary Chemotherapy as Part of De-Escalation of Breast Cancer Treatment

Mohamed I Abdelaziz, S. Monib
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Abstract

Background: Sentinel lymph node biopsy (SLNB) after primary chemotherapy for node-positive breast cancer patients has been gaining popularity as part of the de-escalation of treatment. Aim: The 1ry aim was to assess the surgical outcome of node-positive patients who received primary chemotherapy followed by SLNB. A 2ry aim was to determine the rate of sentinel lymph node identification using the patent blue dye only technique. Methods: A prospective study that included 86 patients with invasive breast cancer and axillary lymph nodes metastasis as proved by ultrasound scan guided core biopsy. Following the completion of primary chemotherapy, sentinel lymph node biopsy was carried out for all patients at the time of breast surgery using the patent blue dye technique. Patients with negative SLNB underwent no further axillary procedure. Completion of axillary lymph node clearance was performed for positive SLNB patients. Results: The sentinel lymph node identification rate using the patent blue dye directed technique was 79%. Sixtyseven (78%) patients underwent wide local excision, and 35% did not need completion of axillary lymph node clearance due to downstaging following primary chemotherapy. Conclusions: Sentinel lymph node biopsy following primary chemotherapy for invasive breast cancer appears to be a safe, reliable technique, with an acceptable identification rate, even when using the patent blue dye technique only.
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原发性化疗后前哨淋巴结活检作为乳腺癌治疗降级的一部分的评估
背景:淋巴结阳性乳腺癌患者原发性化疗后前哨淋巴结活检(SLNB)作为降级治疗的一部分越来越受欢迎。目的:第一个目的是评估淋巴结阳性患者接受原发性化疗后SLNB的手术结果。一个主要的目的是确定前哨淋巴结的识别率使用专利的蓝色染料技术。方法:对86例浸润性乳腺癌伴腋窝淋巴结转移患者进行前瞻性研究,经超声引导下的核心活检证实。在完成初次化疗后,所有患者在乳房手术时使用专利的蓝色染料技术进行前哨淋巴结活检。SLNB阴性的患者不接受进一步的腋窝手术。SLNB阳性患者完成腋窝淋巴结清扫。结果:专利蓝染料定向技术对前哨淋巴结的检出率为79%。67例(78%)患者接受了广泛的局部切除,35%的患者由于初次化疗后分期降低而不需要完成腋窝淋巴结清扫。结论:侵袭性乳腺癌原发性化疗后前哨淋巴结活检似乎是一种安全可靠的技术,即使仅使用专利的蓝色染料技术,也具有可接受的识别率。
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审稿时长
8 weeks
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