Impressions from the San Antonio Breast Cancer Symposium December 2012

摘要

The role of sentinel lymph node biopsy (SNB) in patients receiving neoadjuvant chemotherapy (NAC) is still unclear. 2 abstracts investigated the feasibility and false negative rates of SNB in the neoadjuvant setting. The German SENTINA (SENTInel NeoAdjuvant) trial presented by Kühn et al. (S2–2) was a 4-arm prospective multicenter cohort study designed to evaluate a specific algorithm for the timing of a standardized sentinel lymph node (SLN) procedure in patients who undergo NAC and to provide reliable data for the detection rate (DR) and false negative rate (FNR) in different settings. 1,737 eligible patients from 103 institutions were enrolled in this trial. The DR for SNB was 99% before NAC in clinically node negative patients, 80% in clinically node positive patients receiving SNB after NAC, and 61% after prior SNB and NAC. The SNB was false negative in 14% of patients with cN1/ycNo and SNB after NAC and 52% in patients with re-SNB after NAC. The clinical consequences from these data are that SNB should be performed in cN0 patients before NAC. In cN1 patients who convert to ycN0, SNB is lacking accuracy and should not be performed.