Timing of sentinel lymph node biopsy in breast cancer patients receiving neoadjuvant chemotherapy

摘要

The excellent review of the timing of SLNB (before or after neo-adjuvant chemotherapy [NACT]) by Fontein and colleagues1 suggests that 'current adjuvant treatment incorporates breast and axillary irradiation to further reduce the probability of axillary recurrences'. Two of the very first studies of locoregional therapy conducted by the NSABP are quoted in support of this statement. Practice of course varies but this statement is almost certainly not reflective of modern breast radiotherapy. The lower axilla may be variably treated by the tangential fields used to treat the breast or post mastectomy chest wall,2'3 but thorough axillary radiotherapy when applied as a replacement for surgical axillary node clearance requires in almost all cases additional field/s.