Breast Cancer, Breast MRI, Neoadjuvant Systemic Therapy, Sentinel Lymph Node
Conditions
Brief summary
This study aimed to determine whether sentinel lymph node biopsy (SLNB) could be a reliable option for evaluating nodal status in patients who had responded well to neoadjuvant systemic therapy (NAST), even if they had initially presented with a high nodal burden. The study investigated the outcomes of SLNB followed by axillary lymph node dissection (ALND) in this patient population, taking into account the response to NAST and the breast cancer subtype.
Detailed description
To determine the feasibility of sentinel lymph node biopsy (SLNB) in this study, the investigators evaluated the false-negative rate (FNR) of SLNB. The FNR was calculated as the number of patients with negative SLNs who had a residual disease in the rest of the axillary lymph nodes (ALNs) divided by the total number of patients with residual disease in either the SLNs, the rest of the ALNs, or both: FN/true-positive + FN. The investigators compared the FNR of the SLNB according to the radiologic response measured using breast MRI in each subtype. The investigators further evaluated the FNR in subgroups stratified by clinical nodal stage. Additionally, the investigators assessed additional metastatic ALNs in cases with 1-2 metastatic SLNs through the completion of ALN dissection.
Interventions
PROCEDURESentinel lymph node biopsy followed by axillary lymph node dissection
This is a retrospective study to determine the feasibility of sentinel lymph node biopsy (SLNB) after neoadjuvant systemic therapy (NAST) according to response to NAST and breast cancer subtypes. All patients received SLNB followed by axillary lymph node dissection after NAST.
Sponsors
Gangnam Severance Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
19 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* cN1-3 breast cancer at initial presentation * received neoadjuvant systemic therapy (NAST) * received sentinel lymph node biopsy (SLNB) followed by additional axillary lymph node dissection (ALND) * breast MRI performed at baseline and post-NAST.
Exclusion criteria
* case with unavailable data for breast MRI and operation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| False negative rate of sentinel lymph node biopsy according to radiologic response stratified by brest cancer subtype | up to 1 month after the breast surgery | False negative rate of sentinel lymph node biopsy according to radiologic response stratified by brest cancer subtype |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| False negative rate of sentinel lymph node biopsy according to clinical nodal stage | up to 1 month after the breast surgery | False negative rate of sentinel lymph node biopsy according to clinical nodal stage |
| Additional axillary lymph node metastasis rate in patients with 1-2 metastatic sentinel lymph nodes | up to 1 month after the breast surgery | Additional axillary lymph node metastasis rate in patients with 1-2 metastatic sentinel lymph nodes |
Outcome results
None listed