Feasibility, accuracy and prognosis of sentinel lymph node biopsy before neoadjuvant therapy in breast cancer. A prospective study

INTERNATIONAL JOURNAL OF SURGERY

卷:39

Article

Garcia-Tejedor, Amparo¹  Falo, Catalina²  Quetglas, Cecilia¹  Soler, Teresa³  Marqueta, Belen¹  Ortega, Raul⁴  Gil-Gil, Miguel²  Pernas, Sonia²  Fernandez-Montoli, Eulalia¹  Pla, Maria J.¹  Guma, Anna⁴  Bajen, Maite⁵  Benitez, Ana⁵  Eraso, Arantxa⁶  Campos, Miriam¹  Petit, Anna³  Ponce, Jordi¹ 

[1] Hosp Univ Bellvitge, Multidisciplinary Breast Canc Unit, Dept Gynecol, Barcelona, Spain

[2] Inst Catala Oncol, Multidisciplinary Breast Canc Unit, Dept Oncol, Barcelona, Spain

[3] Hosp Univ Bellvitge, Multidisciplinary Breast Canc Unit, Dept Pathol, Barcelona, Spain

[4] Hosp Univ Bellvitge, Multidisciplinary Breast Canc Unit, Dept Radiol, Barcelona, Spain

[5] Univ Bellvitge, Multidisciplinary Breast Canc Unit Hosp, Dept Nucl Med, Barcelona, Spain

[6] Inst Catala Oncol, Multidisciplinary Breast Canc Unit, Dept Oncol Radiotherapy, Barcelona, Spain

关键词: Sentinel lymph node biopsy;    Neoadjuvant chemotherapy;    Neoadjuvant endocrine therapy;    Breast cancer;   

DOI  :  10.1016/j.ijsu.2017.01.106

来源: Elsevier

【 摘 要 】

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. 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 KaplaneMeier curves. 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). 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. (C) 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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