The Accuracy of Sentinel Lymph Node Biopsy Following Neoadjuvant Chemotherapy in Clinically Node Positive Breast Cancer Patients: A Single Institution Experience

Background: Sentinel lymph node dissection after neoadjuvant chemotherapy is of questionable accuracy. Objectives: In this study, accuracy and feasibility of sentinel lymph node biopsy in patients with breast cancer presented with clinically positive axillary nodes were evaluated. Methods: We conducted a cross sectional study on patients with breast cancer treated at Milad Hospital of Tehran, Iran from June 2014 to February 2015. Clinically node positive patients (proven by biopsy), who became clinically node-negative by ultrasonography and physical examination following neoadjuvant chemotherapy and had been dissected up to 3 lymph nodes according to sentinel lymph node pattern, were included in the study. We used a 2 × 2 contingency table to analyze the feasibility of sentinel lymph node biopsy (sensitivity, specificity, false negative ratio, and accuracy). STATA statistical software (version 13.0, StataCorp LP, Texas, USA) was used for statistical analysis. Results: Among 52 patients, who entered the study, 47 patients had been dissected up to 3 lymph nodes according to sentinel lymph node pattern. We achieved a sensitivity of 100% (16/16), false-negative rate of 0% (0/21), a negative predictive value of 100% (26/26), and an overall accuracy of 89.4%. Conclusions: Sentinel lymph node dissection seems to be feasible and accurate in clinically lymph node positive patients with breast cancer, who achieve a clinically negative node status by ultrasonography and physical examination, following neoadjuvant chemotherapy.