P69 Sentinel lymph node biopsy is feasible for breast cancer patients with clinically negative axillary lymph nodes after neoadjuvant chemotherapy

ackground: The feasibility and accuracy of sentinel lymph node (SLN) biopsy examination for breast cancer patients with clinically ode-negative breast cancer after neoadjuvant chemotherapy (NAC) have been investigated under the administration of a radiocolloid maging agent injected intradermally over a tumor. In addition, conditions that may affect SLN biopsy detection and false-negative rates ith respect to clinical tumor response and clinical nodal status before NAC were analyzed. ethods: Seventy-seven patients with stages II and III breast cancer previously treated with NAC were enrolled in the study. All patients ere clinically node negative after NAC. The patients then underwent SLN biopsy examination, which involved a combination of ntradermal injection over the tumor of radiocolloid and a subareolar injection of blue dye. This was followed by standard level I/II axillary ymph node dissection. esults: The SLN could be identified in 72 of 77 patients (identification rate, 93.5%). In 69 of 72 patients (95.8%) the SLN accurately redicted the axillary status. Three patients had a false-negative SLN biopsy examination result, resulting in a false-negative rate of 11.1% 3 of 27). The SLN identification rate tended to be higher, although not statistically significantly, among patients who had clinically negative xillary lymph nodes before NAC (97.6%; 41 of 42). This is in comparison with patients who had a positive axillary lymph node before AC (88.6%; 31 of 35). onclusions: The SLN identification rate and false-negative rate were similar to those in nonneoadjuvant studies. The SLN biopsy xamination accurately predicted metastatic disease in the axilla of patients with tumor response after NAC and clinical nodal status efore NAC. This diagnostic technique, using an intradermal injection of radiocolloid, may provide treatment guidance for patients fter NAC. © 2006 Excerpta Medica Inc. All rights reserved. The American Journal of Surgery 191 (2006) 225–229