title: Sentinel lymph node biopsy after neo-adjuvant chemotherapy in patients with breast cancer: Are the current false negative rates acceptable?
abstract: The advent of sentinel lymph node biopsy has revolutionised surgical management of axillary nodal disease in patients with breast cancer. Patients undergoing neo-adjuvant chemotherapy for large breast primary tumours may experience complete pathological response on a previously positive sentinel node whilst not eliminating the tumour from the other lymph nodes. Results from 2 large prospective cohort studies investigating sentinel lymph node biopsy after neo-adjuvant chemotherapy demonstrate a combined false negative rate of 12.6-14.2% and identification rate of 80-89% with the minimal acceptable false negative rate and identification rate being set at 10% and 90%, respectively. A false negative rate of 14% would have been classified as unacceptable when compared to the figures obtained by the pioneers of sentinel lymph node biopsy which was 5% or less.
authors: Department of Breast and General Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK; Department of Surgery and Cancer, The Imperial Centre for Translational and Experimental Medicine, Imperial College London, Hammersmith Campus, London, W12 0NN, UK. Electronic address: darren.patten@gmail.com.
authors: D K
authors: DK
authors: Patten
authors: Department of Breast and General Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK.
authors: K E
authors: KE
authors: Zacharioudakis
authors: Department of Breast and General Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK.
authors: H
authors: H
authors: Chauhan
authors: Division of Cancer, Imperial College London, UK.
authors: S J
authors: SJ
authors: Cleator
authors: Department of Breast and General Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK. Electronic address: dhadjiminas@breastsurgeon.co.uk.
authors: D J
authors: DJ
authors: Hadjiminas
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D020360:Neoadjuvant Therapy; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods / Q000706:statistics & numerical data*
keywords: Axillary lymph node status; Breast cancer; Breast cancer diagnostics; Sentinel node biopsy