Sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer

Background: Sentinel lymph node biopsy (SLNB) is a developing alternative t o axillary dissection and may prove to be accurate in the detection of micr ometastases in lymph nodes of breast cancer patients. Limited studies exist in the use of SLNB after neoadjuvant therapy. This study was undertaken to determine the accuracy of SLNB after neoadjuvant chemotherapy. Methods: Thirty-Orle patients with stage I or II breast cancer underwent SL NB after neoadjuvant chemotherapy. Results: Lymphatic mapping was performed by radioisotope, blue dye, or both techniques. Sentinel nodes (SN) were identified in 29 patients (93.5%). Th e SN was positive in 11 patients (38.0%), and was the only positive node in 5 patients (45.5%). There were no false negative SN by hematoxyin and eosi n stain or immunohistochemistry (IHC) studies. Conclusions: Sentinel node identification rate is similar to that in nonneo adjuvant studies. The sentinel node accurately predicted metastatic disease in the axilla. IHC studies failed to detect any additional micrometastases . This diagnostic technique may provide treatment guidance for patients aft er neoadjuvant therapy. (C) 2001 Excerpta Medica, Inc. All rights reserved.