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Sentinel node biopsy for axillary management after neoadjuvant therapy for breast cancer: a single-center retrospective analysis with long follow-up

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Abstract

Purpose

Sentinel node biopsy (SNB) after neoadjuvant therapy (NAT) for breast cancer remains controversial. We conducted a retrospective study of patients who underwent SNB after NAT to evaluate the effectiveness of this procedure.

Methods

A consecutive 105 women with locally advanced breast cancer (cT1–4, cN0–3, M0) were treated with NAT between 2006 and 2015. The subjects were 80 of these patients who became or remained clinically node-negative after NAT, 53 of whom had axillary management determined by SNB (group A) and the other 27 underwent axillary lymph node dissection (ALND) without SNB (group B). SNB was performed using a modified dye method.

Results

The sentinel node (SN) identification rate was 94.3% and the mean number of removed SNs was 2.4. ALND was avoided in 33 patients, who were confirmed as SN-negative. There was no difference in recurrence-free and overall survival rates between groups A and B (p = 0.71 and p = 0.46, respectively) during the median follow-up time of 63 months. Of the 33 patients who did not undergo ALND, 10 suffered recurrence (33%). One patient (3%) had recurrence in an axillary lymph node and four had recurrence in a supraclavicular lymph node.

Conclusion

Axillary SNB after NAT did not affect the axillary failure rate or the prognosis. SNB may be a reliable procedure, even after NAT.

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Acknowledgements

We received no grants for this study. We thank Dr. Bunzo Nakata of Kashihara Municipal Hospital for his advice on our revision. Approved Number for this study by the ethical committee of Osaka City General Hospital: 1612092.

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Authors and Affiliations

  1. Department of Breast Surgical Oncology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan

    Yoshinari Ogawa, Katsumi Ikeda, Chika Watanabe & Yuri Kamei

  2. Department of Medical Oncology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan

    Shinya Tokunaga & Yuko Tsuboguchi

  3. Department of Pathology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan

    Takeshi Inoue & Hiroko Fukushima

  4. Department of Radiology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan

    Makoto Ichiki

Authors
  1. Yoshinari Ogawa
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  2. Katsumi Ikeda
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  3. Chika Watanabe
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Correspondence to Yoshinari Ogawa.

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Ogawa, Y., Ikeda, K., Watanabe, C. et al. Sentinel node biopsy for axillary management after neoadjuvant therapy for breast cancer: a single-center retrospective analysis with long follow-up. Surg Today 48, 87–94 (2018). https://doi.org/10.1007/s00595-017-1558-y

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  • DOI: https://doi.org/10.1007/s00595-017-1558-y

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