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<p>This study evaluated the feasibility, accuracy, and oncological safety of sentinel lymph node biopsy (SLNB) in breast cancer patients who initially presented with node-positive (N1/N2) disease and converted to node-negative (ycN0) status following neoadjuvant chemotherapy (NACT). A prospective observational study was conducted at a tertiary center in New Delhi from July 2022 to July 2024. A total of 120 patients underwent dual-dye SLNB (methylene blue + indocyanine green) followed by complete axillary lymph node dissection. SLNB accuracy was assessed via sensitivity, specificity, and false-negative rate (FNR). SLNB was successfully performed in 97.5% of patients. The sensitivity and specificity of SLNB were 86.27% and 100%, respectively, with an overall FNR of 13.72%. A pathological complete response (pCR) was observed in 37.5% of patients, predominantly in HER2-enriched and triple-negative subtypes. SLNB after NACT is a feasible axillary staging method in ycN0 patients, with high identification rates but an FNR exceeding the ideal 10% threshold. Refinements such as targeted axillary dissection and robust radiologic assessment are essential to improve SLNB accuracy and avoid overtreatment.</p>

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Validation Study of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer

  • 期刊论文

  • 发表日期：

    2026年1月27日

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  • Avneet Kaur,
  • Aditi Chaturvedi,
  • Harit Kumar Chaturvedi,
  • Syed Davood Qasim

摘要

This study evaluated the feasibility, accuracy, and oncological safety of sentinel lymph node biopsy (SLNB) in breast cancer patients who initially presented with node-positive (N1/N2) disease and converted to node-negative (ycN0) status following neoadjuvant chemotherapy (NACT). A prospective observational study was conducted at a tertiary center in New Delhi from July 2022 to July 2024. A total of 120 patients underwent dual-dye SLNB (methylene blue + indocyanine green) followed by complete axillary lymph node dissection. SLNB accuracy was assessed via sensitivity, specificity, and false-negative rate (FNR). SLNB was successfully performed in 97.5% of patients. The sensitivity and specificity of SLNB were 86.27% and 100%, respectively, with an overall FNR of 13.72%. A pathological complete response (pCR) was observed in 37.5% of patients, predominantly in HER2-enriched and triple-negative subtypes. SLNB after NACT is a feasible axillary staging method in ycN0 patients, with high identification rates but an FNR exceeding the ideal 10% threshold. Refinements such as targeted axillary dissection and robust radiologic assessment are essential to improve SLNB accuracy and avoid overtreatment.