Lymph node wire localization post-chemotherapy: Towards improving the false negative sentinel lymph node biopsy rate in breast cancer patients

Brittany Z. Dashevsky*, Ashley Altman, Hiroyuki Abe, Nora Jaskowiak, Jean Bao, David V Schacht, Deepa Sheth, Kirti Kulkarni

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Purpose To evaluate whether the disease status of the pre-neoadjuvant chemotherapy (NAC) core biopsied lymph node (preNACBxLN) in patients with node positive breast cancer corresponds to nodal status of all surgically retrieved lymph nodes (LNs) post-NAC and whether wire localization of this LN is feasible. Materials and methods HIPPA compliant IRB approved retrospective study including breast cancer patients (a.) with preNACBxLN confirmed metastases, (b.) who received NAC, and (c.) underwent wire localization of the preNACBxLN. Electronic medical records were reviewed. Fisher's exact test was used to compare differences in residual disease post-NAC among breast cancer subtypes. Results 28 women with node positive breast cancer underwent ultrasound guided wire localization of the preNACBxLN, without complication. There was no evidence of residual nodal disease for 16 patients, with mean 4.4 (median 4) LNs resected. 12 patients had residual nodal metastases, with mean 9.2 (median 7) LNs resected and mean 2.3 (median 2) LNs with tumor involvement. 11 patients had metastases detected within the localized LN. One patient had micrometastasis in a sentinel LN, despite no residual disease in the preNACBxLN. Patients with luminal A/B breast cancer more often had residual nodal metastases (86%) at pathology, as compared to patients with HER2 + (20%) and Triple Negative breast cancer (50%), though not quite achieving statistical significance (p = 0.055). Conclusion Ultrasound guided wire localization of the preNACBxLN is feasible and may improve detection of residual tumor in patients post-NAC.

Original languageEnglish (US)
Pages (from-to)69-73
Number of pages5
JournalClinical Imaging
Volume48
DOIs
StatePublished - Mar 2018

Keywords

  • Breast cancer
  • Lymph node localization
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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