Preoperative chemotherapy (NAC) has been recognized as the standard of care for patients with locally advanced breast cancer and recently some patients with stage 2 and chemoresponsive subtypes (HER2, TNBC). Lymph node status is the most important prognostic factor in patients who receive neoadjuvant therapy. Patients who have a positive lymph node by fine-needle aspiration (or core needle biopsy) before neoadjuvant therapy usually undergo completion axillary dissection at the time of primary tumor resection. ALND has been the standard treatment of the axilla after NAC for many years. SLNB as an alternative can reduce the extent of axillary surgery without compromising the prognostic and predictive value of axillary staging.
Aim of the work:
The aim of this work was to primarly evaluate the effect of neoadjuvant chemotherapy on axillary nodal status .The secondry objective was to evaluate percentage of patients who are eligible for SLNB post neoadjuvant chemotherapy.
Patients and Methods
Patients
This retrospective study was conducted by collecting data during the period from October 2019 to July 2021.The study included sixty four patients who had biopsy proven locally advanced breast cancer with clinically or radiologically positive axillary LNs, had been received neoadjuvant chemotherapy at clinical oncology department and underwent surgery post neoadjuvant therapy at surgical oncology unit at Alexandria Main University Hospital.