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Sentinel node biopsy after neoadjuvant chemotherapy for breast cancer with axillary node metastasis: A survey of clinical practice.
- Source :
-
Asian journal of surgery [Asian J Surg] 2019 Jan; Vol. 42 (1), pp. 314-319. Date of Electronic Publication: 2018 Jul 23. - Publication Year :
- 2019
-
Abstract
- Background: A survey of breast surgeons was conducted to evaluate changes in clinical practice regarding sentinel node biopsy (SNB) among clinically node-negative patients after neoadjuvant chemotherapy for breast cancer with axillary node metastasis.<br />Methods: We conducted two surveys among 252 members of the Korean Breast Cancer Society. The questionnaire comprised a case presentation and two associated questions. The case outlined a woman diagnosed with right breast cancer; core needle biopsy had confirmed invasive ductal carcinoma and tumor size was 4 cm on imaging examination. Fine needle aspiration examination for axillary lymph node enlargement showed metastatic carcinoma. The patient underwent neoadjuvant chemotherapy and tumor size was decreased by 2 cm; axillary lymph node enlargement was not observed on palpitation or imaging examination. Finally, the patient underwent breast conserving surgery. Survey recipients were asked: 1. Would you perform SNB in this patient? 2. If you perform SNB and no axillary node metastasis is seen, would you perform additional axillary lymph node dissection (ALND)?<br />Results: The response rate was 28.2% (71/252) and 15.1% (38/252) in 2013 and 2017, respectively. For the first question, the SNB to ALND ratio increased significantly from 54% versus 46% in 2013 to 92% versus 8% in 2017 (p < 0.001). The proportion of surgeons performing no additional ALND versus additional ALND increased from 38% versus 54% in 2013 to 53% versus 37% in 2017, but did not reach statistical significance (p = 0.1).<br />Conclusions: These data show that application of SNB among clinically node-negative patients after neoadjuvant chemotherapy for breast cancer with node metastasis has increased among surgeons in Korea.<br /> (Copyright © 2018. Published by Elsevier Taiwan LLC.)
- Subjects :
- Axilla
Female
Humans
Korea
Mastectomy methods
Surveys and Questionnaires
Breast Neoplasms pathology
Breast Neoplasms therapy
Chemotherapy, Adjuvant
Lymph Node Excision statistics & numerical data
Lymph Nodes pathology
Lymphatic Metastasis
Neoadjuvant Therapy
Practice Patterns, Physicians'
Sentinel Lymph Node Biopsy statistics & numerical data
Surgeons
Subjects
Details
- Language :
- English
- ISSN :
- 0219-3108
- Volume :
- 42
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Asian journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30049563
- Full Text :
- https://doi.org/10.1016/j.asjsur.2018.06.004