Our Summary

This research paper looks into the effectiveness and accuracy of a procedure called sentinel lymph node biopsy (SLNB) in diagnosing breast cancer patients who were initially tested positive for breast cancer and underwent a type of treatment called neoadjuvant chemotherapy (NACT).

The researchers checked various medical databases for studies about the use of SLNB after NACT. They included studies where breast cancer patients initially tested positive for cancer in their lymph nodes, received treatment through NACT, and then underwent SLNB.

They looked specifically at the identification rate (how successfully the SLNB could identify the cancer) and the false negative rate (how often the SLNB incorrectly identified no cancer when it was present).

They reviewed 33 studies involving 4624 patients. The results showed that the identification rate ranged from 77.6% to 100%, with an average rate of 88%. The false negative rate ranged from 5.1% to 43%, with an average rate of 13%.

The research also found that using a dual mapping technique could improve the accuracy of the SLNB. They also found that the more lymph nodes that were retrieved and tested, the lower the false negative rate.

Overall, the paper concludes that SLNB after NACT is a feasible and accurate way to diagnose breast cancer in patients who initially tested positive. The procedure is less invasive and can prevent patients from undergoing a more aggressive surgery. The findings suggest that this method should be incorporated into clinical practice, but it’s important to carefully select patients for this procedure and maintain high procedural standards.

FAQs

  1. What is the effectiveness and accuracy of sentinel lymph node biopsy (SLNB) in diagnosing breast cancer after neoadjuvant chemotherapy (NACT)?
  2. How does the use of a dual mapping technique and the retrieval of more lymph nodes impact the accuracy of the SLNB?
  3. How can sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) impact the treatment of breast cancer patients?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about sentinel lymph node biopsy is to discuss the procedure in detail with their healthcare provider and ask any questions they may have. It is important for patients to understand the purpose of the biopsy, how it will be performed, and what to expect during and after the procedure. Patients should also be informed about the possible risks and benefits of the biopsy, as well as any alternative options available. Additionally, patients should follow any pre-operative instructions provided by their healthcare provider to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) are those who have initially tested positive for breast cancer in their lymph nodes. These patients have undergone NACT as a treatment for their cancer and are now undergoing SLNB to accurately diagnose the presence of cancer in their lymph nodes.

The research suggests that SLNB after NACT is a feasible and accurate way to diagnose breast cancer in these patients. The procedure has been shown to have a high identification rate, ranging from 77.6% to 100%, with an average rate of 88%. The false negative rate, which indicates how often the SLNB incorrectly identifies no cancer when it is present, ranged from 5.1% to 43%, with an average rate of 13%.

It is important to carefully select patients for SLNB after NACT and to maintain high procedural standards to ensure the accuracy of the procedure. Using a dual mapping technique and retrieving and testing a higher number of lymph nodes can improve the accuracy of SLNB in these patients. Overall, SLNB after NACT can help prevent patients from undergoing a more aggressive surgery and should be considered as part of the clinical practice for diagnosing breast cancer in patients who initially tested positive for cancer in their lymph nodes.

Timeline

Before sentinel lymph node biopsy:

  1. Patient tests positive for breast cancer
  2. Patient undergoes neoadjuvant chemotherapy (NACT) treatment
  3. Patient is scheduled for sentinel lymph node biopsy to determine if cancer has spread to lymph nodes

After sentinel lymph node biopsy:

  1. Patient undergoes SLNB procedure
  2. SLNB successfully identifies the presence of cancer in the lymph nodes
  3. Treatment plan is adjusted based on SLNB results
  4. Patient may undergo additional treatment or surgery based on SLNB findings
  5. Patient receives follow-up care and monitoring for recurrence or progression of cancer.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sentinel lymph node biopsy (SLNB) include:

  1. What is the purpose of a sentinel lymph node biopsy in my case?
  2. How will the SLNB be performed and what can I expect during the procedure?
  3. What are the potential risks and complications associated with SLNB?
  4. How accurate is the SLNB in identifying cancer in the lymph nodes?
  5. What is the false negative rate of SLNB in my specific situation?
  6. Will a dual mapping technique be used during the SLNB to improve accuracy?
  7. How many lymph nodes will be retrieved and tested during the SLNB?
  8. How will the results of the SLNB impact my treatment plan?
  9. Are there any alternative or additional tests that can provide more information about the lymph nodes?
  10. What are the criteria for selecting patients for SLNB after neoadjuvant chemotherapy?

Reference

Authors: Zahwe M, Ghzaiel A, Najia A, Soueid L, El Asmar K, Ghezzawi M, El Iskandarani S, Diab M, El Jibbawi M, Hoteit R, Sbaity E. Journal: Int J Surg. 2025 Apr 1;111(4):3040-3050. doi: 10.1097/JS9.0000000000002275. PMID: 39878175