False Negative Rate of Sentinel Lymph Node Biopsy (SLNB) in Breast Cancer Patients after Neoadjuvant Chemotherapy False negative rate after SLNB

Ramesh Omranipour (1), Seyed Mohammad Mehdi Ghaffari Hamedani (2), Sadaf Alipour (3), Shiller Hesamiazar (4), Bita Eslami (5)
(1) Breast Diseases Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran/Department of Surgical Oncology, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(2) Department of Surgery, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran, Iran, Islamic Republic of,
(3) Breast Diseases Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran/Department of Surgery, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(4) Breast Diseases Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(5) Breast Cancer Research Center, Tehran University of Medical Sciences, Korea, Republic of

Abstract

Background: Managing the axilla in patients with node-positive breast cancer who converted to node-negative patients after neoadjuvant chemotherapy is a challenging issue. We aim to analyze the false negative rate (FNR) of SLNB after neoadjuvant chemotherapy in this group of patients.


Methods: In this cross-sectional study, we reviewed the results of SLNB and ALND in 368 breast cancer patients who underwent neoadjuvant chemotherapy from 2015 to 2019. The study included patients with pathologically proven axillary lymph nodes undergoing NAC. We collected the data from the Breast Diseases Research Center of Tehran University of Medical Sciences.


Results: The average age of the patients was 46.58±10.91. Of all the patients, 205 (55.7%) had positive SLN in the histologic analysis after surgery, while 163 (44.3%) had negative results. The study also revealed that the FNR of SLNB was 9.8% (n=16). Our results showed that SLN had 86.55% sensitivity and 100% specificity in detecting involved nodes. Furthermore, after multivariable analysis, we observed that a higher number of ALND dissections were associated with a higher FNR (Odds ratio; OR=1.20, 95% CI: 1.02-1.42); while a higher number of SLN excisions was linked with a lower FNR (OR=0.41; 95% CI: 0.17-0.98).


Conclusion: After NAC in breast cancer patients with positive lymph nodes, SLNB is feasible with a low FNR; the latter is correlated with the number of nodes removed during the procedure.

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Authors

Ramesh Omranipour
Seyed Mohammad Mehdi Ghaffari Hamedani
Sadaf Alipour
Shiller Hesamiazar
Bita Eslami
dr.bes.96@gmail.com (Primary Contact)
1.
Omranipour R, Ghaffari Hamedani SMM, Alipour S, Hesamiazar S, Eslami B. False Negative Rate of Sentinel Lymph Node Biopsy (SLNB) in Breast Cancer Patients after Neoadjuvant Chemotherapy: False negative rate after SLNB. Arch Breast Cancer [Internet]. [cited 2024 Jul. 14];11(3). Available from: https://www.archbreastcancer.com/index.php/abc/article/view/959

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