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Background: Managing the axilla in patients with node-positive breast cancer who converted to node-negative patients after neoadjuvant chemotherapy is a challenging issue. We aim to analyze the false negative rate (FNR) of SLNB after neoadjuvant chemotherapy in this group of patients. Methods: In this cross-sectional study, we reviewed the results of SLNB and ALND in 368 breast cancer patients who underwent neoadjuvant chemotherapy from 2015 to 2019. The study included patients with pathologically proven axillary lymph nodes undergoing NAC. We collected the data from the Breast Diseases Research Center of Tehran University of Medical Sciences. Results: The average age of the patients was 46.58±10.91. Of all the patients, 205 (55.7%) had positive SLN in the histologic analysis after surgery, while 163 (44.3%) had negative results. The study also revealed that the FNR of SLNB was 9.8% (n=16). Our results showed that SLN had 86.55% sensitivity and 100% specificity in detecting involved nodes. Furthermore, after multivariable analysis, we observed that a higher number of ALND dissections were associated with a higher FNR (Odds ratio; OR=1.20, 95% CI: 1.02-1.42); while a higher number of SLN excisions was linked with a lower FNR (OR=0.41; 95% CI: 0.17-0.98). Conclusion: After NAC in breast cancer patients with positive lymph nodes, SLNB is feasible with a low FNR; the latter is correlated with the number of nodes removed during the procedure.
Omranipour et al. (Wed,) studied this question.