title: Accurate axillary lymph node dissection is feasible after neoadjuvant chemotherapy.
abstract: 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.
authors.affiliation: Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. m.straver@nki.nl
authors.forename: Marieke E
authors.initials: ME
authors.lastname: Straver
authors.forename: Emiel J T
authors.initials: EJ
authors.lastname: Rutgers
authors.forename: Hester S A
authors.initials: HS
authors.lastname: Oldenburg
authors.forename: Jelle
authors.initials: J
authors.lastname: Wesseling
authors.forename: Sabine C
authors.initials: SC
authors.lastname: Linn
authors.forename: Nicola S
authors.initials: NS
authors.lastname: Russell
authors.forename: Marie-Jeanne T F D
authors.initials: MJ
authors.lastname: Vrancken Peeters
mesh_terms: 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
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane