Lymphatic mapping and sentinel lymphadenectomy after preoperative therapy for stage II and III breast cancer

Glen C. Balch, Suhail K. Mithani, Ken R. Richards, R. Daniel Beauchamp, Mark C. Kelley

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Background: We evaluated the accuracy of sentinel lymph node dissection (SLND) in patients with stage II and III breast cancer who had received preoperative therapy. Methods: A prospective clinical trial evaluated 122 patients who had SLND followed by axillary lymph node dissection. Thirty-two women had stage II or III breast cancer and received preoperative doxorubicin-based chemotherapy or paclitaxel and radiotherapy. Results: A sentinel lymph node (SLN) was identified in 31 (97%) of 32 patients. The SLN predicted the status of the axillary nodes in 30 (97%) of 31 patients. Eighteen (58%) of 31 had metastases in the SLN. Eighteen of 19 patients with axillary metastases had a tumor-positive SLN (sensitivity, 95%; false-negative rate, 5%). Eight (44%) of 18 women with metastases in the SLN also had metastases in 1 or more nonsentinel nodes. Conclusions: In this relatively small study, the accuracy of SLND in women with stage II or III breast cancer treated with preoperative therapy was similar to that achieved in early-stage breast cancer. If these results are confirmed in a larger cohort, it may be feasible to substitute SLND for routine axillary lymph node dissection in this population. This approach could reduce the morbidity of surgical therapy while preserving the accuracy of axillary staging and maintaining regional control in this high-risk population.

Original languageEnglish (US)
Pages (from-to)616-621
Number of pages6
JournalAnnals of Surgical Oncology
Volume10
Issue number6
DOIs
StatePublished - 2003

Fingerprint

Lymph Node Excision
Breast Neoplasms
Neoplasm Metastasis
Therapeutics
cyhalothrin
Sentinel Lymph Node
Paclitaxel
Doxorubicin
Population
Radiotherapy
Clinical Trials
Morbidity
Drug Therapy

Keywords

  • Breast cancer
  • Lymphatic mapping
  • Preoperative chemotherapy
  • Preoperative radiotherapy
  • Sentinel lymph node dissection

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Lymphatic mapping and sentinel lymphadenectomy after preoperative therapy for stage II and III breast cancer. / Balch, Glen C.; Mithani, Suhail K.; Richards, Ken R.; Beauchamp, R. Daniel; Kelley, Mark C.

In: Annals of Surgical Oncology, Vol. 10, No. 6, 2003, p. 616-621.

Research output: Contribution to journalArticle

Balch, Glen C. ; Mithani, Suhail K. ; Richards, Ken R. ; Beauchamp, R. Daniel ; Kelley, Mark C. / Lymphatic mapping and sentinel lymphadenectomy after preoperative therapy for stage II and III breast cancer. In: Annals of Surgical Oncology. 2003 ; Vol. 10, No. 6. pp. 616-621.
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