Determining the involvement of sentinel lymph nodes in breast cancer patients with axillary lymphadenopathy after neoadjuvant chemotherapy

Abstract

Various studies have demonstrated the utility of sentinel lymph node biopsy in diagnosing axillary lymph node involvement. This procedure has a positive impact on patients' quality of life, with complications such as lymphedema, range of motion limitations, pain, and sensory disturbances being significantly less common in patients undergoing sentinel lymph node biopsy compared to those who receive standard axillary lymph node dissection. The present study aims to evaluate the outcomes of sentinel lymph node biopsy following neoadjuvant chemotherapy in patients with breast cancer and axillary lymph node involvement. Materials and Methods: In this cross-sectional descriptive study, after obtaining ethical approval and patient consent, 32 patients with breast cancer and positive lymph nodes, classified as STAGE 2B or 3A, who were referred to Imam Reza Hospital and Vali Asr Hospital in Tabriz were examined. The patients, identified and selected, underwent neoadjuvant chemotherapy under the supervision of an oncologist. The course of treatment for the selected patients was evaluated during standard surgical procedures for sentinel lymph node assessment using the isotope injection method (scintigraphy). Specifically, a standard dose (0.5 mCi) of sulfur colloid labeled with Technetium-99m (99mTc) was injected into the tumor site one hour before surgery. A radioisotope counter was used to identify the sentinel lymph node. After identifying the sentinel lymph node, it was removed and sent for frozen section analysis as well as permanent pathology evaluation. Subsequently, axillary lymph node dissection was performed during the standard breast surgery. Results: It was found that SLN removal in breast cancer patients had a sensitivity of 76%, a specificity of 100%, and a false-negative rate of 20%.