Resende HM, Lichtenfels M, Soares IC, Renó AACL, Cunha AP, Falcão PG, Pieroni CSP, Assis BRD, Cardoso P, Marassi PHA, Reis RDS. Sentinel lymph node biopsy using single-agent mapping tracer (blue dye) after neoadjuvant chemotherapy in a Brazilian cohort of breast cancer patients. Real world evidence.
Acta Cir Bras 2021;
36:e360608. [PMID:
34231654 PMCID:
PMC8253600 DOI:
10.1590/acb360608]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/10/2021] [Indexed: 12/01/2022] Open
Abstract
Purpose
To reduce false-negative rates (FNR) in sentinel lymph node biopsy (SLNB) of
clinically positive (cN+) axilla in patients undergoing neoadjuvant
chemotherapy (NAC). The removal of three or more lymph nodes with
dual-tracer mapping including a radioisotope was used. However, in the
Brazilian Unified Health System, the radioisotope tracer is not feasible in
some hospitals. We conducted a cross-sectional study to evaluate the
detection rate of sentinel lymph node (SLN) in patients who converted from
cN+ to ycN0 after NAC using blue dye as a single-agent mapping tracer.
Methods
During the period of March 2018 to September 2019, 34 patients who underwent
NAC with cN+ who converted to ycN0 were enrolled in the study. The SLNB was
performed using blue dye as a single-agent mapping followed by axillary
lymph node dissection (ALND).
Results
The detection rate of sentinel lymph node was of 85.3%, being SLNB not
possible for five patients (14.7%), due to fibrosis. The mean number of
removed SLN was 2.5.
Conclusions
The use of blue dye as a single-agent mapping tracer demonstrated an
acceptable detection rate of 85.3%. Although the FNR was possible to be
determined, the small sample size might overestimate this rate. The removal
of three or more lymph nodes with single-agent mapping tracer might be
indicated for breast cancer patients who converted to ycN0 after NAC in the
Brazilian health public services, in which radioisotope tracer is not
suitable.
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