Sentinel lymph node biopsy after neoadjuvant chemotherapy in inflammatory breast cancer.
BACKGROUND
Sentinel lymph node biopsy (SLNB) demonstrates promising results as an accurate alternative to axillary lymph node dissection in patients with locally advanced breast cancer after neoadjuvant chemotherapy (NAC). However and in the view of the insufficient data on women with inflammatory breast cancer (IBC), SLNB is not recommended in this situation. The current study assessed identification and false-negative rates of SLNB after NAC for patients with IBC.


METHODS
Between 2006 and 2009, twenty consecutive patients with clinically negative nodes after NAC for IBC (T4d) and who underwent SLNB and axillary lymph node dissection (levels I and II) by the same operator were assessed. Intraoperative Sentinel lymph node biopsy was performed with patent blue dye injections.


RESULTS
The SLN could be identified in 16 of 20 patients (identification rate, 80%), the median of SLN removed per patient was 2 (range 1-3); nine (56%) had positive SLNB, and in 2 of those 9 patients (22%), the SLN was the only positive node with otherwise negative axillary nodes. Two (18%) patients' SLNB were false negative.


CONCLUSIONS
The SLN identification and false-negative rates after NAC for IBC were unacceptably high and based on the current findings, SLNB without systematic axillary lymph node dissection is unsuitable in this patient population.
Obstetrics & Gynecology Department, Farhat Hached University Teaching Hospital, Sousse 4002, Tunisia. hidar.samir@gnet.tn
Samir
S
Hidar
Mohamed
M
Bibi
Olfa
O
Gharbi
Sameh
S
Tebra
Amel
A
Trabelsi
Sadok
S
Korbi
Nouredine
N
Bouaouina
Slim
S
Ben Ahmed
Hédi
H
Khaïri
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D021701:Sentinel Lymph Node Biopsy