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Prior surgery reduced success rate of sentinel lymph node biopsy
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SAN ANTIONIO — Prior systemic or surgical treatment significantly lowered the success rates of sentinel lymph node biopsy, according to a study presented at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium.
The most ideal time to undergo a sentinel lymph node biopsy is unclear for patients with breast cancer undergoing chemotherapy treatment. The success rates are also unclear for patients who were downstaged from a clinically node-positive to a clinically node-negative status, according to background information in the study.
Thorsten Kuehn, MD, of the department of gynecology and obstetrics for the Project Group for Interdisciplinary Senology in Germany, and colleagues designed the four-arm prospective, multicenter SENTINA trial to find a specific standardized sentinel lymph node biopsy procedure in patients who undergo treatment.
The trial included 1,737 eligible patients from 103 institutions.
Researchers classified patients with clinically node-negative status who underwent sentinel lymph node biopsy before systemic treatment, if the lymph node was histologically negative and no further surgery was performed, as Arm A (n=662). Patients with histologically positive lymph node status who had a second sentinel lymph node biopsy performed after primary treatment were classified as Arm B (n=360).
Patients who converted to clinically node negative after treatment, and both sentinel lymph node biopsy and axillary dissection were performed, were classified as Arm C (n=592). Patients presenting with clinically node-positive status after treatment and who underwent classical axillary dissection were classified as Arm D (n=123).
According to the data results from the study, the false negative rate of sentinel lymph node was 14.2% (95% CI, 9.9-19.4) in patients who underwent a sentinel lymph node biopsy before systemic treatment. After systemic treatment, the false negative rate increased to 51.6% (95% CI, 38.7-64.2).
For more information:
Kuehn T. #S2-2. Presented at: the 2012 CTRC-AACR San Antonio Breast Cancer Symposium; Dec. 4-8, 2012; San Antonio.
Disclosure: Kuehn and colleagues report no relevant financial disclosures.