Originally published as JCO Early Release 10.1200/JCO.2008.18.3228 on December 29 2008

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Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy for Advanced Breast Cancer: Results of Ganglion Sentinelle et Chimiothérapie Neoadjuvante, a French Prospective Multicentric Study

From the Departments of Surgery and Statistics, Comprehensive Cancer Center, Centre René Gauducheau, Nantes, Saint Herblain; Surgical Department, Comprehensive Cancer Center, Centre Léon Bérard, Lyon; Gynecological Department, University Hospital, Rennes; Department of Pathology, University Hospital, Nantes; Gynecological Department, University Hospital, Brest; Gynecological Department, University Hospital, Tours; and the Department of Surgery, Comprehensive Cancer Center, Centre Oscar Lambret, Lille, France.

Corresponding author: Jean-Marc Classe, MD, PhD, Centre rene Gauducheau de Nantes, Bd J Monod, 44805 Saint-Herblain, France; e-mail: jm-classe{at}nantes.fnclcc.fr.

Purpose To determine the detection rate, the false-negative rate, and the accuracy of sentinel lymph node (SLN) detection after neoadjuvant chemotherapy (NAC) for advanced breast cancer.

Patients and Methods A prospective multicentric study was initiated to evaluate the results of SLN biopsy with the combined method after NAC for advanced large operable breast cancer.

Results From September 2003 to March 2007, 195 patients enrolled from 12 institutions were found suitable for evaluation. The detection rate was 90% (176 of 195 patients), and the false-negative rate was 11.5% (six of 52 patients). Patients without axillary palpable nodes (N0) before NAC had a better detection rate compared with patients with axillary suspicious nodes (N1, 94.6% v 81.5%; P = .008). The false-negative rate was not correlated with clinical nodal status before NAC (9.4% v 15%; P = .66).

Conclusion This study confirms the feasibility of SLN biopsy after NAC in the case of large operable breast cancer. The detection rate, false-negative rate, and accuracy do not differ from those obtained in the case of early breast cancer without NAC, thus demonstrating the feasibility of SLN biopsy after NAC.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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