Accurate axillary lymph node dissection is feasible after neoadjuvant chemotherapy.
BACKGROUND
Recently, lower axillary lymph node retrieval after neoadjuvant chemotherapy was reported. We did not have this experience, and retrospectively analyzed our axillary lymph node dissections (ALNDs).


METHODS
One hundred ninety-one patients who had ALND after neoadjuvant chemotherapy were compared with 192 patients with primary ALND after a positive sentinel node biopsy.


RESULTS
There were no differences in the mean number of nodes retrieved between the neoadjuvant group and the primary surgery group: 16.3 (range 4-38) and 15.8 (range 6-33), respectively (P = .4); or in the retrieval of fewer than 10 lymph nodes: 13/191 (7%) and 11/192 (6%) (P = .7). The number of cases with retrieval of more than 20 lymph nodes was higher in the neoadjuvant group: 42/191 (22%) versus 26/192 (13%) (P = .03). In the neoadjuvant group, 150/191 (79%) patients had residual lymph node metastasis after neoadjuvant chemotherapy.


CONCLUSIONS
Our results show the feasibility and need to remove enough lymph nodes to provide precise prognostic information and adequate local control.
Straver
Marieke E
ME
Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. m.straver@nki.nl
Rutgers
Emiel J T
EJ
Oldenburg
Hester S A
HS
Wesseling
Jelle
J
Linn
Sabine C
SC
Russell
Nicola S
NS
Vrancken Peeters
Marie-Jeanne T F D
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001365:Axilla; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D001952:Bridged-Ring Compounds / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000592:standards*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D043823:Taxoids / Q000627:therapeutic use; D013997:Time Factors; D055815:Young Adult
D018943:Anthracyclines; D000970:Antineoplastic Agents; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane