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Sentinal LN Biopsy for Breast Cancer
- 1. Timing of SLN procedure should be performed before or after administration of neoadjuvant chemotherapy? Adune Ratanawichitrasin MD
- 2. Axilla staging surgery Best for node negative patients Best for node positive patients Sentinel lymph node biopsy Axillary lymph node dissections
- 3. Targeted populations Stage 0 Stage I Stage II Stage III Stage IV Node Negative Node Positive No need for SLN No need for SLN
- 4. Targeted populations Stage 0 Stage I Stage II Stage III Stage IV Node Negative Node Positive More benefits More efforts
- 5. Targeted populations Stage 0 Stage I Stage II Stage III Stage IV Node Negative Node Positive More benefits Node Negative after neo adjuvant More efforts
- 6. Targeted populations Stage 0 Stage I Stage II Stage III Stage IV Node Negative Node Positive More benefits Node Negative after neo adjuvant Node Negative before neo adjuvant More efforts
- 7. Benefit of SLN Bx in neoadjuvant breast cancer patients •In patients who has negative node or turn to be negative node after neoadjuvant •How accurate SLN Bx
- 8. Limitation of using SLN Bx in neoadjuvant settings Before neoadjuvant or After neoadjuvant
- 9. Identification rate 100% Negative nodes 22/52 cases = 42% 1 progressive node during neoadjuvant J.L. Jones et al. / The American Journal of Surgery 190 (2005) 517–520
- 10. After neoadjuvant Identification rate 81% false negative 15% Negative 11/36 cases = 31% J.L. Jones et al. / The American Journal of Surgery 190 (2005) 517–520
- 11. Success 82-100% False Negative 11 % After neoadjuvant Charfare H. et al. / BJS 2005; 92: 14–23
- 12. After neoadjuvant All 53 patients has positive node before neoadjuvant chemotherapy Additional 32% node negative cases Newman EA, et al. / Annals of Surgical Oncology 14(10):2946–2952
- 13. The SENTINA study 2,234 patients Neo-adjuvant
- 14. Neo-adjuvant The SENTINA study 2,234 patients 99% 60% 80%
- 15. The SENTINA study 2,234 patients 52% 14% Neo-adjuvant
- 16. The SENTINA study 2,234 patients Neo-adjuvant Detection rate 60% 80% False negative rate 52% 14%