Volume 25, Issue 109, March, 2021

Sentinel lymph node biopsy following neoadjuvant chemotherapy for breast cancer patients with axillary node metastasis: A cross-sectional survey

Nuha Alsaleh^1♦, Amal Alhefdhi², Abdullah I Aljunaydil³

¹Division of Breast and Endocrine, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
²Division of Breast and Endocrine, Department of Surgery, AlFaisal University and King Faisal Specialist Hospital and Research Center (KFSH) Riyadh, Saudi Arabia
³College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia

^♦Corresponding author
Associate Professor and Consultant, Breast and Endocrine Surgeon, Division of Breast and Endocrine, Department of surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; Email: dr.nuhaalsaleh@gmail.com

ABSTRACT

Background: A survey of breast surgeons in Saudi Arabia was conducted to evaluate changes in clinical practice regarding sentinel node biopsy (SNB) among clinically node-negative patients after neoadjuvant chemotherapy for breast cancer with axillary node metastasis. Methods and Materials: The study was conducted in a tertiary university hospital in Riyadh between August and October 2020 and utilized a 22-question, online survey to examine various factors leading to the omission of axillary lymph node dissection (ALND) among KSA breast surgeons. The questions pertained to basic demographics and the participant’s cited influencing factors. Cross-tabulation and the chi-square square test were used to analysis subgroups, and binary logistics regression was used to assess doctor-related factors contributing to a decision to omit ALND after NAC. Results: A total of 24 participants completed the survey. The proportion of surgeons preferring SLNB adjunctively or replaced by axillary radiotherapy in patients with clinically positive axilla and receiving NAC was 70.8%. Conclusion: The implementation of SLNB post-neoadjuvant chemotherapy has led to a wide variation in clinical practice. Further prospective randomized clinical trials should be conducted in order to evaluate the clinical outcomes of SNB versus more conventional therapies.

Keywords: Breast, cancer, surgery, sentinel lymph node biopsy, neoadjuvant chemotherapy

Medical Science, 2021, 25(109), 632-639

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