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Advantage of sentinel lymph node biopsy before neoadjuvant chemotherapy in breast cancer treatment
Surgery Today, 05/04/09

Iwase H et al. - In a review of sentinel lymph node biopsy (SLNB)before neoadjuvant chemotherapy in breast cancer treatment, it seems that to identify the initial cancer stage in pts who will be treated by systemic therapy before surgery, SLNB should be performed prior to systemic treatments, using a well-developed navigating tool, such as single photon emission computed tomography (CT, SPECT).

Methods

Accurate identification of SLNs preoperatively is of clinical importance.
SLNB causes less lymph edema of the upper arm than axillary lymph node dissection (ALND) with a high accuracy rate and low false-negative rate (FNR).
Neoadjuvant chemotherapy (NAC) can be given not only to pts with locally advanced breast cancer, but also to those with axillary lymph node metastasis and an operable tumor.

Results

SLNB after NAC results in a lower identification rate and a higher FNR than SLNB before treatment.
A hybrid imaging device has been developed, which consists of SPECT and a low-dose CT installed on the same platform.
This imaging system offers an easy and safe method of performing SLNB under local anesthesia.

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