Introduction:
Axillary
dissection is increasingly less indicated for axillary evaluation of
patients with
breast cancer and clinically negative
axilla. This study evaluated the application of
sentinel lymph node in
patients with clinical axillary remission after
neoadjuvant chemotherapy.
Methods:
Prospective study carried out from December 2017 to July 2018, at the Liga Norte Riograndense Contra o
Cancer. We considered 24
patients who had a positive
axilla and after
neoadjuvant chemotherapy had clinical axillary remission (ypN0). Only
patients with a strongly positive status during
physical examination were included, and
biopsy and ultrasound examinations were not required to confirm axillary
disease. The dual-tracer
technique of
sentinel lymph node biopsy followed by axillary
dissection was used.
Results:
The accuracy of the
sentinel lymph node in
patients with clinical axillary remission was 91.7%, with a false negative rate of 13.3% (2/24). It was observed that 66.6% of
patients were stage I after
chemotherapy and 13
patients with negative
sentinel lymph node biopsy no longer had axillary
disease. During the
sentinel lymph node biopsy procedure, 16
patients (79.1%) had only 1
sentinel lymph node removed.
Conclusions:
For
patients with clinical axillary remission after
neoadjuvant chemotherapy,
sentinel lymph node biopsy has been included in clinical practice, reducing the indications for axillary
dissection and, consequently, its
morbidity. The dual-agent mapping
technique of
sentinel lymph node biopsy and a sample of 3
lymph nodes at
surgery decrease false-negative rates and make the
procedure safer.