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Sentinel Lymph Node Biopsy and Neoadjuvant Chemotherapy in Breast Cancer Patients

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Personalized Treatment of Breast Cancer

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Abstract

Patient selection and timing of sentinel lymph node (SLN) biopsy in the context of primary chemotherapy continues to evolve; there is some evidence that primary chemotherapy may modify lymphatic drainage patterns and cause differential downstaging between sentinel and non-sentinel lymph nodes. SLN biopsy undertaken prior to chemotherapy will minimise the risk of a false-negative result, may allow more accurate initial staging and provides important information on prognostication which can guide decisions about adjuvant radiotherapy. However, quantification of regional metastatic load is incomplete, and some advocate SLN biopsy after primary chemotherapy to take advantage of nodal downstaging and avoidance of axillary dissection in up to 40 % of patients. Initial reports on false-negative rates for SLN biopsy after primary chemotherapy in patients who had proven axillary node metastases at presentation based on needle core biopsy were relatively high and a cause for clinical concern. However, more recent data suggest that SLN biopsy is as accurate when performed post- as pre-neoadjuvant chemotherapy, and current practice incorporates both approaches.

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Author information

Authors and Affiliations

  1. Cambridge Breast Unit, Addenbrooke’s Hospital and University of Cambridge, Hills Road, Cambridge, CB2 0QQ, UK

    John R. Benson

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  1. John R. Benson
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Correspondence to John R. Benson .

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Editors and Affiliations

  1. Department of Breast Surgery Graduate Sc, Kyoto University, Kyoto, Kyoto, Japan

    Masakazu Toi

  2. Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA

    Eric Winer

  3. Addenbrooke’s Hospital, Cambridge University Hospitals, Cambridge, Cambridgeshire, United Kingdom

    John Benson

  4. University of Arkansas for Medical Scien, Little Rock, Arkansas, USA

    Suzanne Klimberg

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Benson, J.R. (2016). Sentinel Lymph Node Biopsy and Neoadjuvant Chemotherapy in Breast Cancer Patients. In: Toi, M., Winer, E., Benson, J., Klimberg, S. (eds) Personalized Treatment of Breast Cancer. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55552-0_4

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  • DOI: https://doi.org/10.1007/978-4-431-55552-0_4

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