title: [Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer. Its relation with molecular subtypes].
abstract: OBJECTIVE
  To evaluate the influence of the molecular subtype (MS) in the Sentinel Node Biopsy (SNB) technique after neoadjuvant chemotherapy (NAC) in women with locally advanced breast cancer (BC) and a complete axillary response (CR).
  
  
  METHODS
  A prospective study involving 70 patients with BC treated with NAC was carried out. An axillary lymph node dissection was performed in the first 48 patients (validation group: VG), and in case of micro- or macrometastases in the therapeutic application phase (therapy group:TG). Classified according to MS: 14 luminal A; 16 luminal B HER2-, 13 luminal B HER2+, 10HER2+ non-luminal, 17 triple-negative.
  
  
  RESULTS
  SNB was carried out in 98.6% of the cases, with only one false negative result in the VG (FN=2%). Molecular subtype did not affect SN detection. Despite the existence of axillary CR, statistically significant differences were found in the proportion of macrometastasis (16.7% vs. 35.7%, p=0.043) on comparing the pre-NAC cN0 and cN+. Breast tumor response to NAC varied among the different MS, this being lowest in luminal A (21.5%) and highest in non-luminal HER2+ group (80%). HER2+ and triple-negative were the groups with the best axillary histological response both when there was prior clinical involvement and when there was not.
  
  
  CONCLUSIONS
  Molecular subtype is a predictive factor of the degree of tumor response to NAC in breast cancer. However, it does not affect SNB detection and efficiency. SNB can also be used safely in women with prior node involvement as long as a complete clinical and radiological assessment is made of the node response to NAC.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario de Salamanca, Salamanca, España. Electronic address: richardrua@hotmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Ruano
authors.affiliation: Unidad de Patología Mamaria, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: M
authors.initials: M
authors.lastname: Ramos
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: J R
authors.initials: JR
authors.lastname: García-Talavera
authors.affiliation: Unidad de Patología Mamaria, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: T
authors.initials: T
authors.lastname: Ramos
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: A S
authors.initials: AS
authors.lastname: Rosero
authors.affiliation: Unidad de Patología Mamaria, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: J M
authors.initials: JM
authors.lastname: González-Orus
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: M
authors.initials: M
authors.lastname: Sancho
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001365:Axilla; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry / Q000145:classification / Q000556:secondary* / Q000628:therapy; D002277:Carcinoma / Q000737:chemistry / Q000145:classification / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D000077143:Docetaxel; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D000069585:Filgrastim / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009363:Neoplasm Proteins / Q000032:analysis*; D009367:Neoplasm Staging; D009376:Neoplasms, Hormone-Dependent / Q000737:chemistry / Q000556:secondary / Q000628:therapy; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D043823:Taxoids / Q000008:administration & dosage; D000068878:Trastuzumab / Q000008:administration & dosage; D064726:Triple Negative Breast Neoplasms / Q000737:chemistry / Q000556:secondary / Q000628:therapy
chemical_list: D014408:Biomarkers, Tumor; D003520:Cyclophosphamide; D000077143:Docetaxel; D015251:Epirubicin; D000069585:Filgrastim; D005472:Fluorouracil; D009363:Neoplasm Proteins; D017239:Paclitaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; D043823:Taxoids; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Axillary staging; Cáncer mama localmente avanzado; Estadificación axilar; Ganglio centinela; Locally advanced breast cancer; Molecular subtypes; Neoadjuvant chemotherapy; Quimioterapia neoadyuvante; Sentinel node; Subtipo molecular