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Predicting Additional Metastases in Axillary Lymph Node Dissection After Neoadjuvant Chemotherapy: Ratio of Positive/Total Sentinel Nodes

  • 0Department of Obstetrics and Gynecology and Neonatology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.
Cancers +

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November 9, 2024

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November 9, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

The sentinel lymph node ratio (SLN-R) can predict additional positive lymph nodes in breast cancer patients after neoadjuvant chemotherapy (NAC). An SLN-R cut-off of <0.35 may help omit axillary lymph node dissection (ALND).

Area Of Science

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background

  • Accurate staging of axillary lymph nodes is critical for breast cancer treatment.
  • Neoadjuvant chemotherapy (NAC) can downstage axillary lymph nodes, complicating staging.
  • Predictive markers are needed to guide decisions on axillary lymph node dissection (ALND) after NAC.

Purpose Of The Study

  • To evaluate the clinical utility of the sentinel lymph node ratio (SLN-R) in predicting additional positive lymph nodes.
  • To assess the SLN-R's ability to identify breast cancer patients who may not require axillary lymph node dissection (ALND) after neoadjuvant chemotherapy (NAC).

Main Methods

  • A cross-sectional study of 118 breast cancer patients who received NAC and had positive axillary staging (SLN/TAD) followed by ALND.
  • Univariate logistic regression and ROC curve analysis were used to determine the predictive value of SLN-R.
  • Identified an SLN-R cut-off point to predict residual disease in axillary lymph nodes.

Main Results

  • The sentinel lymph node ratio (SLN-R) showed significant predictive value (OR 7.79, p=0.003).
  • An SLN-R cut-off of <0.35 was identified with a 10.2% false-negative rate for predicting no additional metastasis.
  • This cut-off effectively identified patients with no residual disease after NAC.

Conclusions

  • SLN-R is a valuable tool for predicting additional positive lymph nodes in breast cancer patients post-NAC.
  • The SLN-R can aid in the decision-making process for omitting axillary lymph node dissection (ALND) when sentinel lymph node biopsy is positive.
  • Incorporating SLN-R into clinical practice may help spare eligible patients from unnecessary ALND.

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