Should we do sentinel lymph node biopsy after neoadjuvant chemotherapy?
Association of Breast Surgery ePoster Library. Popa E. 05/13/19; 257069; P025
Elena Popa
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P025
Topic: Axilla
Aim:There is a controversy with regard to timing of sentinel lymph node biopsy (SLNB) in patients undergoing neo-adjuvant chemotherapy (NAC). In our hospital, patients having NAC undergo SLNB prior to neoadjuvant chemotherapy. Aim of our study was to assess the incidence of further axillary disease at ALND after NAC and compare with those not receiving NAC. Methods :Retrospective review of patients undergoing ALND with positive sentinel nodes between January 2016 to December 2017 at Peterborough City Hospital. Data were collected from the cancer and pathology registries. Patients who had ALND were divided into 2 groups; group 1 underwent ALND after NAC and group 2 who did not have NAC. Statistical difference between the 2 groups were calculated using fisher's exact test.Result:SLNB were performed in 455 patents. Only 5 patients (18%) in group 1 had further metastasis on ALND as compared to 39% in group 2 as shown in table 1. However, the difference between the 2 groups was not statistically significant (P> 0.09). Five other patients in group 1 showed only fibrosis.Table 1No of patientsMean age YearsMean tumour sizemmGrade 3%Triple -ve%Further nodal metastasis on ALNDPatients (%)Group 128474854145 (18%)Group 238602945815 (39%)ConclusionSLNB after NAC could avoid unnecessary ALND because of downstaging of the disease. Larger randomised controlled trial should be done to establish the long-term outcome of SLNB after NAC.
Topic: Axilla
Aim:There is a controversy with regard to timing of sentinel lymph node biopsy (SLNB) in patients undergoing neo-adjuvant chemotherapy (NAC). In our hospital, patients having NAC undergo SLNB prior to neoadjuvant chemotherapy. Aim of our study was to assess the incidence of further axillary disease at ALND after NAC and compare with those not receiving NAC. Methods :Retrospective review of patients undergoing ALND with positive sentinel nodes between January 2016 to December 2017 at Peterborough City Hospital. Data were collected from the cancer and pathology registries. Patients who had ALND were divided into 2 groups; group 1 underwent ALND after NAC and group 2 who did not have NAC. Statistical difference between the 2 groups were calculated using fisher's exact test.Result:SLNB were performed in 455 patents. Only 5 patients (18%) in group 1 had further metastasis on ALND as compared to 39% in group 2 as shown in table 1. However, the difference between the 2 groups was not statistically significant (P> 0.09). Five other patients in group 1 showed only fibrosis.Table 1No of patientsMean age YearsMean tumour sizemmGrade 3%Triple -ve%Further nodal metastasis on ALNDPatients (%)Group 128474854145 (18%)Group 238602945815 (39%)ConclusionSLNB after NAC could avoid unnecessary ALND because of downstaging of the disease. Larger randomised controlled trial should be done to establish the long-term outcome of SLNB after NAC.
P025
Topic: Axilla
Aim:There is a controversy with regard to timing of sentinel lymph node biopsy (SLNB) in patients undergoing neo-adjuvant chemotherapy (NAC). In our hospital, patients having NAC undergo SLNB prior to neoadjuvant chemotherapy. Aim of our study was to assess the incidence of further axillary disease at ALND after NAC and compare with those not receiving NAC. Methods :Retrospective review of patients undergoing ALND with positive sentinel nodes between January 2016 to December 2017 at Peterborough City Hospital. Data were collected from the cancer and pathology registries. Patients who had ALND were divided into 2 groups; group 1 underwent ALND after NAC and group 2 who did not have NAC. Statistical difference between the 2 groups were calculated using fisher's exact test.Result:SLNB were performed in 455 patents. Only 5 patients (18%) in group 1 had further metastasis on ALND as compared to 39% in group 2 as shown in table 1. However, the difference between the 2 groups was not statistically significant (P> 0.09). Five other patients in group 1 showed only fibrosis.Table 1No of patientsMean age YearsMean tumour sizemmGrade 3%Triple -ve%Further nodal metastasis on ALNDPatients (%)Group 128474854145 (18%)Group 238602945815 (39%)ConclusionSLNB after NAC could avoid unnecessary ALND because of downstaging of the disease. Larger randomised controlled trial should be done to establish the long-term outcome of SLNB after NAC.
Topic: Axilla
Aim:There is a controversy with regard to timing of sentinel lymph node biopsy (SLNB) in patients undergoing neo-adjuvant chemotherapy (NAC). In our hospital, patients having NAC undergo SLNB prior to neoadjuvant chemotherapy. Aim of our study was to assess the incidence of further axillary disease at ALND after NAC and compare with those not receiving NAC. Methods :Retrospective review of patients undergoing ALND with positive sentinel nodes between January 2016 to December 2017 at Peterborough City Hospital. Data were collected from the cancer and pathology registries. Patients who had ALND were divided into 2 groups; group 1 underwent ALND after NAC and group 2 who did not have NAC. Statistical difference between the 2 groups were calculated using fisher's exact test.Result:SLNB were performed in 455 patents. Only 5 patients (18%) in group 1 had further metastasis on ALND as compared to 39% in group 2 as shown in table 1. However, the difference between the 2 groups was not statistically significant (P> 0.09). Five other patients in group 1 showed only fibrosis.Table 1No of patientsMean age YearsMean tumour sizemmGrade 3%Triple -ve%Further nodal metastasis on ALNDPatients (%)Group 128474854145 (18%)Group 238602945815 (39%)ConclusionSLNB after NAC could avoid unnecessary ALND because of downstaging of the disease. Larger randomised controlled trial should be done to establish the long-term outcome of SLNB after NAC.
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