Would Removal of All Ultrasound Abnormal Metastatic Lymph Nodes Without Sentinel Lymph Node Biopsy Be Accurate in Patients with Breast Cancer with Neoadjuvant Chemotherapy?

The Oncologist
Geok Hoon LimLester Chee Hao Leong

Abstract

Removal of sonographically abnormal (up to 3) metastatic clipped nodes, without sentinel lymph node biopsy, could accurately predict axillary status in breast cancer patients receiving neoadjuvant chemotherapy. ypT and the first clipped node status were statistically significant factors for nodal pathologic complete response. This novel approach requires validation in larger studies. In patients who have node-positive breast cancer, neoadjuvant chemotherapy could result in nodal pathologic complete response (pCR) and avoid an axillary lymph node dissection (ALND). Axillary staging, in such cases, can be performed using targeted axillary dissection (TAD) with a low false negative rate. However, identification of sentinel lymph nodes (SLNs) after chemotherapy can be difficult, and currently, it is the standard to remove only one clipped node in TAD. We aimed to determine if removal of all sonographically abnormal metastatic clipped nodes, without SLN biopsy, could accurately predict the axillary status post neoadjuvant chemotherapy. Patients with breast cancer with one to three sonographically abnormal metastatic axillary nodes were prospectively recruited. Each abnormal node had histology and clip insertion before neoadjuvant ch...Continue Reading

References

Jul 1, 1997·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·B FisherN V Dimitrov
Oct 9, 2013·JAMA : the Journal of the American Medical Association·Judy C BougheyUNKNOWN Alliance for Clinical Trials in Oncology
Jan 27, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Abigail S CaudleHenry M Kuerer
May 1, 2018·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Geok Hoon LimLester Chee Hao Leong

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