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Subject Area

General Surgery

Article Type

Original Study

Abstract

Background Sentinel lymph-node biopsy (SLNB) has been established as the standard management for pathologic evaluation of the axilla in patients with operable breast cancer and clinically negative axilla (cN0). However, whether SLNB should be performed for patients with node-positive disease after neoadjuvant chemotherapy (NAC) is still controversial. Patients and methods This is a clinical multiinstitutional prospective study conducted on 340 patients with operable breast cancer selected from the multidisciplinary breast clinic at Menoufia University Hospital and Tanta Oncology Centre to evaluate the suitability of SLNB for patients with node-negative (group A) and node-positive (group B) breast cancer after NAC. The study was performed from October 2016 to October 2020. Results The identification rate for SLNB after NAC was 90.45% and the false-negative rate was 12.5%. The sensitivity, specificity, positive predictive value, and negative predictive value were 98, 91, 90, and 93.5%, respectively. The overall accuracy for SLNB after NAC was 95%. Conclusion SLNB after NAC has acceptable false-negative rate, identification rate, and lower in both morbidity and cost. Patients with no initially involved nodes (cN0) with a negative SLN after NAC could safely be spared an unnecessary axillary lymph-node dissection with a low risk of relapse.

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