• Rev Esp Med Nucl Imagen Mol · Jul 2016

    Multicenter Study

    Validation of sentinel lymph node biopsy in breast cancer women N1-N2 with complete axillary response after neoadjuvant chemotherapy. Multicentre study in Tarragona.

    • D Carrera, M de la Flor, J Galera, K Amillano, M Gomez, V Izquierdo, E Aguilar, S López, M Martínez, S Martínez, J M Serra, M Pérez, and L Martin.
    • Servicio de Medicina Nuclear, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España.
    • Rev Esp Med Nucl Imagen Mol. 2016 Jul 1; 35 (4): 221-5.

    IntroductionThe aim of our study was to evaluate sentinel lymph node biopsy as a diagnostic test for assessing the presence of residual metastatic axillary lymph nodes after neoadjuvant chemotherapy, replacing the need for a lymphadenectomy in negative selective lymph node biopsy patients.Material And MethodsA multicentre, diagnostic validation study was conducted in the province of Tarragona, on women with T1-T3, N1-N2 breast cancer, who presented with a complete axillary response after neoadjuvant chemotherapy. Study procedures consisted of performing an selective lymph node biopsy followed by lymphadenectomy.ResultsA total of 53 women were included in the study. Surgical detection rate was 90.5% (no sentinel node found in 5 patients). Histopathological analysis of the lymphadenectomy showed complete disease regression of axillary nodes in 35.4% (17/48) of the patients, and residual axillary node involvement in 64.6% (31/48) of them. In lymphadenectomy positive patients, 28 had a positive selective lymph node biopsy (true positive), while 3 had a negative selective lymph node biopsy (false negative). Of the 28 true selective lymph node biopsy positives, the sentinel node was the only positive node in 10 cases. All lymphadenectomy negative cases were selective lymph node biopsy negative. These data yield a sensitivity of 93.5%, a false negative rate of 9.7%, and a global test efficiency of 93.7%.ConclusionsSelective lymph node biopsy after chemotherapy in patients with a complete axillary response provides valid and reliable information regarding axillary status after neoadjuvant treatment, and might prevent lymphadenectomy in cases with negative selective lymph node biopsy.Copyright © 2016 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

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