Sentinel Lymph Node Biopsy After Chemotherapy

Giuliano AE, Dale PS, Turner RR, et al. Improved axillary staging of breast cancer with sentinel lymphadenectomy. Ann Surg. 1995;222:394–9. discussion 399–401. Giuliano AE, Jones RC, Brennan M, et al. Sentinel lymphadenectomy in breast cancer. J Clin Oncol. 1997;15:2345–50. Mansel RE, Fallowfield L, Kissin M, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006;98:599–609. Wilke LG, McCall LM, Posther KE, et al. Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol. 2006;13:491–500. Lucci A, McCall LM, Beitsch PD, et al. Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. J Clin Oncol. 2007;25:3657–63. McLaughlin SA, Wright MJ, Morris KT, et al. Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements. J Clin Oncol. 2008;26:5213–9. Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol. 2010;11:927–33. Boughey JC, Middleton LP, Harker L, et al. Utility of ultrasound and fine-needle aspiration biopsy of the axilla in the assessment of invasive lobular carcinoma of the breast. Am J Surg. 2007;194:450–5. Boughey JC, Moriarty JP, Degnim AC, et al. Cost modeling of preoperative axillary ultrasound and fine-needle aspiration to guide surgery for invasive breast cancer. Ann Surg Oncol. 2010;17:953–8. Alvarez S, Anorbe E, Alcorta P, et al. Role of sonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review. AJR Am J Roentgenol. 2006;186:1342–8. Bedrosian I, Reynolds C, Mick R, et al. Accuracy of sentinel lymph node biopsy in patients with large primary breast tumors. Cancer. 2000;88:2540–5. Kim T, Giuliano AE, Lyman GH. Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis. Cancer. 2006;106:4–16. Kuerer HM, Sahin AA, Hunt KK, et al. Incidence and impact of documented eradication of breast cancer axillary lymph node metastases before surgery in patients treated with neoadjuvant chemotherapy. Ann Surg. 1999;230:72–8. Bear HD, Anderson S, Brown A, et al. The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide: preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2003;21:4165–74. Buzdar AU, Ibrahim NK, Francis D, et al. Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol. 2005;23:3676–85. Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol. 1997;15:2483–93. •• Giuliano AE, McCall L, Beitsch P, et al: Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 252:426–32; discussion 432–3, 2010. Critical work evaluating the role of avoiding completion ALND for patients with positive SLN undergoing breast-conserving therapy. This study was a recently reported prospective randomized trial comparing women with T1 and T2 breast cancers with 1 to 2 positive SLNs and receiving whole breast radiation randomized between SLN alone and SLN with completion ALND. Local-regional recurrence was no different between the two groups. This is the largest study of its kind and will likely not be repeated. Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305(6):569–75. Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol. 2008;26:778–85. Newman LA, Pernick NL, Adsay V, et al. Histopathologic evidence of tumor regression in the axillary lymph nodes of patients treated with preoperative chemotherapy correlates with breast cancer outcome. Ann Surg Oncol. 2003;10:734–9. Sakakibara M, Nagashima T, Kadowaki M, et al. Clinical significance of axillary microresiduals after neoadjuvant chemotherapy in breast cancer patients with cytologically proven metastases. Ann Surg Oncol. 2009;16:2470–8. Beatty JD, Precht LM, Lowe K, et al. Axillary-conserving surgery is facilitated by neoadjuvant chemotherapy of breast cancer. Am J Surg. 2009;197:637–41. discussion 641–2. Kim HJ, Son BH, Lim WS, et al. Impact of omission of axillary lymph node dissection after negative sentinel lymph node biopsy: 70-month follow-up. Ann Surg Oncol. 2010;17:2126–31. Degnim AC, Zakaria S, Boughey JC, et al. Axillary recurrence in breast cancer patients with isolated tumor cells in the sentinel lymph node [AJCC N0(i+)]. Ann Surg Oncol. 2010;17:2685–9. Naik AM, Fey J, Gemignani M, et al. The risk of axillary relapse after sentinel lymph node biopsy for breast cancer is comparable with that of axillary lymph node dissection: a follow-up study of 4008 procedures. Ann Surg. 2004;240:462–8. discussion 468–71. Langer I, Marti WR, Guller U, et al. Axillary recurrence rate in breast cancer patients with negative sentinel lymph node (SLN) or SLN micrometastases: prospective analysis of 150 patients after SLN biopsy. Ann Surg. 2005;241:152–8. Fournier K, Schiller A, Perry RR, et al. Micrometastasis in the sentinel lymph node of breast cancer does not mandate completion axillary dissection. Ann Surg. 2004;239:859–63. discussion 863–5. Hwang RF, Gonzalez-Angulo AM, Yi M, et al. Low locoregional failure rates in selected breast cancer patients with tumor-positive sentinel lymph nodes who do not undergo completion axillary dissection. Cancer. 2007;110:723–30. Nason KS, Anderson BO, Byrd DR, et al. Increased false negative sentinel node biopsy rates after preoperative chemotherapy for invasive breast carcinoma. Cancer. 2000;89:2187–94. Xing Y, Foy M, Cox DD, et al. Meta-analysis of sentinel lymph node biopsy after preoperative chemotherapy in patients with breast cancer. Br J Surg. 2006;93:539–46. van Deurzen CH, Vriens BE, Tjan-Heijnen VC, et al. Accuracy of sentinel node biopsy after neoadjuvant chemotherapy in breast cancer patients: a systematic review. Eur J Cancer. 2009;45:3124–30. Kelly AM, Dwamena B, Cronin P, et al. Breast cancer sentinel node identification and classification after neoadjuvant chemotherapy-systematic review and meta analysis. Acad Radiol. 2009;16:551–63. Fisher B, Redmond C, Fisher ER, et al. Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation. N Engl J Med. 1985;312:674–81. •• Hunt KK, Yi M, Mittendorf EA, et al: Sentinel Lymph Node Surgery After Neoadjuvant Chemotherapy is Accurate and Reduces the Need for Axillary Dissection in Breast Cancer Patients. Ann Surg 250:558–66, 2009. Report on 575 cases of SLN biopsy after neoadjuvant chemotherapy compared to 3171 cases with SLN prior to any chemotherapy in clinically node-negative patients. SLN false-negative rate was similar in the two groups and there were no differences in local-regional recurrences, disease-free survival, or overall survival between the groups. Although retrospective, it is a large study supporting the idea that SLN biopsy after chemotherapy is accurate and decreases the need for axillary dissection. •• Brown AS, Hunt KK, Shen J, et al: Histologic changes associated with false-negative sentinel lymph nodes after preoperative chemotherapy in patients with confirmed lymph node-positive breast cancer before treatment. Cancer 116:2878–83, 2010. Study looking at the histologic changes in SLNs from patients with documented node-positive breast cancer prior to the initiation of neoadjuvant chemotherapy, followed by SLN and ALND after completion of chemotherapy. It found a false-negative rate of 22%, which is why ALND remains the current standard of care for these patients. Lack of identification of histologic changes in the SLN may indicate false-negative SLNs. Gimbergues P, Abrial C, Durando X, et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy is accurate in breast cancer patients with a clinically negative axillary nodal status at presentation. Ann Surg Oncol. 2008;15:1316–21. Stearns V, Ewing CA, Slack R, et al. Sentinel lymphadenectomy after neoadjuvant chemotherapy for breast cancer may reliably represent the axilla except for inflammatory breast cancer. Ann Surg Oncol. 2002;9:235–42. Hidar S, Bibi M, Gharbi O, et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy in inflammatory breast cancer. Int J Surg. 2009;7:272–5. Baslaim MM, Al Malik OA, Al-Sobhi SS, et al. Decreased axillary lymph node retrieval in patients after neoadjuvant chemotherapy. Am J Surg. 2002;184:299–301. Belanger J, Soucy G, Sideris L, et al. Neoadjuvant chemotherapy in invasive breast cancer results in a lower axillary lymph node count. J Am Coll Surg. 2008;206:704–8. Neuman H, Carey LA, Ollila DW, et al. Axillary lymph node count is lower after neoadjuvant chemotherapy. Am J Surg. 2006;191:827–9. Boughey JC, Donohue JH, Jakub JW, et al. Number of lymph nodes identified at axillary dissection: effect of neoadjuvant chemotherapy and other factors. Cancer. 2010;116:3322–9.