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Role of Sentinel Lymph Node Biopsy with Blue Dye Only after Neoadjuvant Systemic Treatment in Patients with Breast Cancer Who Had Biopsy-Proven Node-Positive Disease at Admission: SENATURK-ROSANNA Study

  • 0Department of General Surgery, University of Health Sciences, Istanbul Haydarpaşa Numune Training and Research Hospital, Istanbul, Türkiye.
Breast Care +

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October 9, 2025

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October 9, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Sentinel lymph node biopsy (SLNB) using only blue dye after neoadjuvant systemic treatment (NST) in breast cancer patients with initially metastatic lymph nodes is oncologically safe. This approach showed low axillary recurrence rates, supporting its clinical viability.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background

  • Neoadjuvant systemic treatment (NST) downstages axillary lymph nodes (ALNs) in breast cancer patients.
  • Sentinel lymph node biopsy (SLNB) after NST can have high false-negative rates (FNRs), especially with fewer than 3 nodes or a single tracer.
  • Targeted axillary dissection is an alternative but is costly and resource-intensive.

Purpose Of The Study

  • To evaluate axillary recurrence rates in breast cancer patients with initially metastatic ALNs who underwent downstaging by NST and subsequent SLNB using only blue dye.
  • To assess the oncological safety and adequacy of SLNB with blue dye alone in this patient population.

Main Methods

  • Retrospective analysis of 245 breast cancer patients with initially pN+ ALNs treated between 2010-2021.
  • Patients received NST and underwent SLNB using blue dye alone, achieving ypN0 or ypN0[i+] status.
  • Follow-up data on recurrence (breast, axilla, regional lymphatics, distant) and mortality were collected.

Main Results

  • 10% had cN2 disease, 35% had <3 sentinel lymph nodes retrieved.
  • After SLNB, 6% had isolated tumor cells; the remainder had a pathologic complete response.
  • Median follow-up was 51 months; only 2% experienced ipsilateral axillary recurrence (0.8% isolated).
  • Overall recurrence was 18% (primarily distant); mortality was 9%.

Conclusions

  • SLNB using only blue dye after NST is a viable and acceptable approach for breast cancer patients with initially metastatic lymph nodes.
  • The oncological safety and adequacy of this simplified SLNB method warrant further investigation in larger studies.

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