The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review
Background: In clinically node-positive (cN+) breast cancer (BC) patients who become clinically node-negative (cN0) following neoadjuvant chemotherapy (NACT), sentinel lymph node biopsy (SLNB) after lymphatic mapping with lymphoscintigraphy is not widely accepted; therefore, it has become a topic of...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/10/630 |
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| author | Giulia Ferrarazzo Alberto Nieri Emma Firpo Andrea Rattaro Alessandro Mignone Flavio Guasone Augusto Manzara Giuseppe Perniciaro Stefano Spinaci |
| author_facet | Giulia Ferrarazzo Alberto Nieri Emma Firpo Andrea Rattaro Alessandro Mignone Flavio Guasone Augusto Manzara Giuseppe Perniciaro Stefano Spinaci |
| author_sort | Giulia Ferrarazzo |
| collection | DOAJ |
| description | Background: In clinically node-positive (cN+) breast cancer (BC) patients who become clinically node-negative (cN0) following neoadjuvant chemotherapy (NACT), sentinel lymph node biopsy (SLNB) after lymphatic mapping with lymphoscintigraphy is not widely accepted; therefore, it has become a topic of international debate. Objective: Our literature review aims to evaluate the current use of this surgical practice in a clinical setting and focuses on several studies published in the last six years which have contributed to the assessment of the feasibility and accuracy of this practice, highlighting its importance and oncological safety. We have considered the advantages and disadvantages of this technique compared to other suggested methods and strategies. We also evaluated the role of local irradiation therapy after SLNB and state-of-the-art SLN mapping in patients subjected to NACT. Methods: A comprehensive search of PubMed and Cochrane was conducted. All studies published in English from 2018 to August 2023 were evaluated. Results: Breast units are moving towards a de-escalation of axillary surgery, even in the NACT setting. The effects of these procedures on local irradiation are not very clear. Several studies have evaluated the oncological outcome of SLNB procedures. However, none of the alternative techniques proposed to lower the false negative rate (FNR) of SLNB are significant in terms of prognosis. Conclusions: Based on these results, we can state that lymphatic mapping with SLNB in cN+ BC patients who become clinically node-negative (ycN0) following NACT is a safe procedure, with a good prognosis and low axillary failure rates. |
| first_indexed | 2024-03-10T21:19:12Z |
| format | Article |
| id | doaj.art-0f66c7ab75d84f87824088f6e22669f6 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T21:19:12Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-0f66c7ab75d84f87824088f6e22669f62023-11-19T16:10:36ZengMDPI AGCurrent Oncology1198-00521718-77292023-09-0130108703871910.3390/curroncol30100630The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature ReviewGiulia Ferrarazzo0Alberto Nieri1Emma Firpo2Andrea Rattaro3Alessandro Mignone4Flavio Guasone5Augusto Manzara6Giuseppe Perniciaro7Stefano Spinaci8Nuclear Medicine, Ospedale Villa Scassi ASL3, 16149 Genova, ItalyNuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Cona, ItalyBreast Surgery, Department of Surgery, Ospedale Villa Scassi ASL3, 16149 Genova, ItalyBreast Surgery, Department of Surgery, Ospedale Villa Scassi ASL3, 16149 Genova, ItalyNuclear Medicine, Ospedale Villa Scassi ASL3, 16149 Genova, ItalyBreast Surgery, Department of Surgery, Ospedale Villa Scassi ASL3, 16149 Genova, ItalyNuclear Medicine, Ospedale Villa Scassi ASL3, 16149 Genova, ItalyDivision of Plastic and Reconstructive Surgery, Burn Unit, Ospedale Villa Scassi ASL3, 16149 Genova, ItalyBreast Unit, Department of Surgery, Ospedale Villa Scassi ASL3, 16149 Genova, ItalyBackground: In clinically node-positive (cN+) breast cancer (BC) patients who become clinically node-negative (cN0) following neoadjuvant chemotherapy (NACT), sentinel lymph node biopsy (SLNB) after lymphatic mapping with lymphoscintigraphy is not widely accepted; therefore, it has become a topic of international debate. Objective: Our literature review aims to evaluate the current use of this surgical practice in a clinical setting and focuses on several studies published in the last six years which have contributed to the assessment of the feasibility and accuracy of this practice, highlighting its importance and oncological safety. We have considered the advantages and disadvantages of this technique compared to other suggested methods and strategies. We also evaluated the role of local irradiation therapy after SLNB and state-of-the-art SLN mapping in patients subjected to NACT. Methods: A comprehensive search of PubMed and Cochrane was conducted. All studies published in English from 2018 to August 2023 were evaluated. Results: Breast units are moving towards a de-escalation of axillary surgery, even in the NACT setting. The effects of these procedures on local irradiation are not very clear. Several studies have evaluated the oncological outcome of SLNB procedures. However, none of the alternative techniques proposed to lower the false negative rate (FNR) of SLNB are significant in terms of prognosis. Conclusions: Based on these results, we can state that lymphatic mapping with SLNB in cN+ BC patients who become clinically node-negative (ycN0) following NACT is a safe procedure, with a good prognosis and low axillary failure rates.https://www.mdpi.com/1718-7729/30/10/630sentinel lymph node biopsybreast cancerneoadjuvant chemotherapysurgery |
| spellingShingle | Giulia Ferrarazzo Alberto Nieri Emma Firpo Andrea Rattaro Alessandro Mignone Flavio Guasone Augusto Manzara Giuseppe Perniciaro Stefano Spinaci The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review Current Oncology sentinel lymph node biopsy breast cancer neoadjuvant chemotherapy surgery |
| title | The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review |
| title_full | The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review |
| title_fullStr | The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review |
| title_full_unstemmed | The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review |
| title_short | The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review |
| title_sort | role of sentinel lymph node biopsy in breast cancer patients who become clinically node negative following neo adjuvant chemotherapy a literature review |
| topic | sentinel lymph node biopsy breast cancer neoadjuvant chemotherapy surgery |
| url | https://www.mdpi.com/1718-7729/30/10/630 |
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