Sentinel lymph node biopsy using single-agent mapping tracer (blue dye) after neoadjuvant chemotherapy in a Brazilian cohort of breast cancer patients. Real world evidence

ABSTRACT Purpose To reduce false-negative rates (FNR) in sentinel lymph node biopsy (SLNB) of clinically positive (cN+) axilla in patients undergoing neoadjuvant chemotherapy (NAC). The removal of three or more lymph nodes with dual-tracer mapping including a radioisotope was used. However, in the B...

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Bibliographic Details
Published in:	Acta cirúrgica brasileira Vol. 36; no. 6
Main Authors:	Resende, Heloisa Magda, Lichtenfels, Martina, Soares, Igor Camargo, Renó, Angélica Araújo Cortines Laxe, Cunha, Ana Paula, Falcão, Pedro Gustavo, Pieroni, Carolina Soares Pimentel, Assis, Biazi Ricieri de, Cardoso, Paola, Marassi, Pedro Henrique Adário, Reis, Rafael dos Santos
Format:	Journal Article
Language:	English
Published:	Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia 01-01-2021
Subjects:	Breast Neoplasms Clinical Investigation Lymph Node Excision Neoadjuvant Therapy Sentinel Lymph Node Biopsy
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Summary:	ABSTRACT Purpose To reduce false-negative rates (FNR) in sentinel lymph node biopsy (SLNB) of clinically positive (cN+) axilla in patients undergoing neoadjuvant chemotherapy (NAC). The removal of three or more lymph nodes with dual-tracer mapping including a radioisotope was used. However, in the Brazilian Unified Health System, the radioisotope tracer is not feasible in some hospitals. We conducted a cross-sectional study to evaluate the detection rate of sentinel lymph node (SLN) in patients who converted from cN+ to ycN0 after NAC using blue dye as a single-agent mapping tracer. Methods During the period of March 2018 to September 2019, 34 patients who underwent NAC with cN+ who converted to ycN0 were enrolled in the study. The SLNB was performed using blue dye as a single-agent mapping followed by axillary lymph node dissection (ALND). Results The detection rate of sentinel lymph node was of 85.3%, being SLNB not possible for five patients (14.7%), due to fibrosis. The mean number of removed SLN was 2.5. Conclusions The use of blue dye as a single-agent mapping tracer demonstrated an acceptable detection rate of 85.3%. Although the FNR was possible to be determined, the small sample size might overestimate this rate. The removal of three or more lymph nodes with single-agent mapping tracer might be indicated for breast cancer patients who converted to ycN0 after NAC in the Brazilian health public services, in which radioisotope tracer is not suitable.
Bibliography:	Conflict of interest: Nothing to declare Authors’ contribution: Conception and design: Resende HM and Lichtenfels M; Data acquisition, analysis and interpretation: Resende HM, Soares IC, Renó AACL, Cunha AP, Pieroni CSP, Falcão PG, Cardoso P, Marassi PHA, Reis RS; Manuscript preparation: Resende HM, Lichtenfels M and Assis BR; Critical revision: Resende HM, Lichtenfels M and Assis BR.
ISSN:	0102-8650 1678-2674
DOI:	10.1590/acb360608