E-ISSN: 2587-0831 ISSN: 2587-0831
Extended Sentinel Node Biopsy in Breast Cancer Patients who Achieve Complete Nodal Response with Neoadjuvant Chemotherapy
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Review
VOLUME: 16 ISSUE: 2
P: 99-105
April 2020

Extended Sentinel Node Biopsy in Breast Cancer Patients who Achieve Complete Nodal Response with Neoadjuvant Chemotherapy

Eur J Breast Health 2020;16(2):99-105
DOI: 10.5152/ejbh.2020.4730
Alfredo Carlos Simões Dornellas de Barros
Danúbia Ariana de Andrade
1. Hospital Beneficência Portuguesa de São Paulo, Mastology, São Paulo, Brazil
No information available.
No information available
Received Date: 15.11.2019
Accepted Date: 17.03.2020
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ABSTRACT

Neoadjuvant chemotherapy (NAC) can eradicate axillary disease in breast cancer (BC) patients. Sentinel node biopsy (SNB) in patients with positive axilla who accomplish complete clinical response after NAC is a new opportunity for changing paradigms and decreasing the extension and the morbidity of axillary surgery. The aim of this article is to review the limits of SNB in this setting and present the current status of an expanded modification of this technique. False-negative rates (FNRs) of conventional SNB exceed the threshold of 10%, and are not acceptable. The extended SNB (ESNB) entails the removal of at least 3 lymph nodes (LNs) including the sentinel node (SN) mapped by dual tracers and a marked lymph node (LN) that was found previously metastatic. This node by node removal procedure greatly reduces the FNRs of the procedure. Despite that axillary lymph node dissection (ALND) is still the standard of care for patients with involved LNs before NAC, the ESNB is a valid option for selected patients in whom axillary positive disease is converted to negative. When ESNB is negative in such cases (immunohistochemistry included), the omission of ALND seems to be safe.