Does lymph node status prior to neoadjuvant chemotherapy influence the number of sentinel nodes removed? Journal Article


Authors: Baker, J. L.; Muhsen, S.; Zabor, E. C.; Stempel, M.; Gemignani, M. L.
Article Title: Does lymph node status prior to neoadjuvant chemotherapy influence the number of sentinel nodes removed?
Abstract: Background/Objective: Recent prospective trials support the use of sentinel lymph node biopsy (SLNB) in breast cancer patients after neoadjuvant chemotherapy (NAC) with a lower false-negative rate if three or more sentinel lymph nodes (SLNs) are identified. In this study, we investigated whether the pre-NAC axillary lymph node status influences the number of SLNs identified. Methods: Stage I–III breast cancer patients who received NAC and underwent SLNB from May 2014 to April 2016 were identified from an institutional prospective database. Clinical and pathological factors among clinically node-negative (cN−) and clinically node-positive (cN+) patients who converted to cN− post-NAC were compared. Generalized linear mixed models analyzed factors associated with the number of SLNs removed. Results: Among 343 patients who underwent SLNB during the study period, 335 (98%) had at least one SLN identified, and subsequently comprised the study population. The median number of SLNs identified was 4 (range 1–14), which did not differ according to pre-NAC nodal status (P = 0.15). Overall, 85% of patients had three or more SLNs identified (80% cN− group vs. 89% cN+ group; P = 0.02). On univariable analysis, age < 50 years and presenting with a positive axillary node were significantly associated with identifying three or more SLNs. Conclusions: Our study confirms that SLNB was successfully performed in 98% of our patients after NAC, with very few failed mapping procedures. In the post-NAC setting, the median number of SLNs identified was four, and the status of the axilla prior to NAC did not negatively affect the number of SLNs identified. © 2018, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 26
Issue: 2
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2019-02-01
Start Page: 336
End Page: 342
Language: English
DOI: 10.1245/s10434-018-7004-6
PUBMED: 30506175
PROVIDER: scopus
PMCID: PMC6342628
DOI/URL:
Notes: Export Date: 1 February 2019 -- Source: Scopus
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MSK Authors
  1. Mary L Gemignani
    142 Gemignani
  2. Emily Craig Zabor
    121 Zabor
  3. Shirin Muhsen
    25 Muhsen
  4. Michelle Moccio Stempel
    126 Stempel
  5. Jennifer Lynn Baker
    2 Baker