Sentinel Lymph Node Biopsy in T3 and T4b Breast Cancer Patients: Analysis in a Tertiary Cancer Hospital and Systematic Literature Review

Abstract

<b><i>Introduction:</i></b> Breast cancer represents the most common type of cancer among women in the world. The presence and extent of axillary lymph node involvement represent an important prognostic factor. Sentinel lymph node biopsy (SLNB) is currently accepted for T1 and T2 with negative axillae (N0); however, many patients with T3-T4b tumors with N0 are often submitted to unnecessarily axillary lymph node dissection. <b><i>Materials and Methods:</i></b> This is a retrospective, observational study of patients treated for breast cancer between 2008 and 2015, with T3/T4b tumors and N0, who underwent SLNB. A systematic review of the literature was also carried out in 5 bases. <b><i>Results:</i></b> We analyzed 73 patients, and SLNB was negative for macrometastasis in 60.3% of the cases. With a mean follow-up of 45 months, no ipsilateral axillary local recurrence was observed. In the systematic review, only 7 articles presented data for analysis. Grouping these studies with the present series, the rate of N0 was 32.1% for T3 and 61.0% for T4b; grouping all studies (T3 and T4b <i>n</i> = 431) the rate was 32.5%. <b><i>Conclusions:</i></b> SLNB in T3/T4b tumors is a feasible and safe procedure from the oncological point of view, as it has not been associated with ipsilateral axillary relapse.

Survival After Sentinel Lymph Node Biopsy Compared with Axillary Lymph Node Dissection for Female Patients with T3-4c Breast Cancer

“…We found 2 studies that demonstrated the feasibility of SLNB in patients with T3/T4b breast cancer. One was a retrospective study conducted by de Oliveira et al, 11 involving 73 patients with T3/T4b breast cancer. They found that the identification rate of SLNB was 100%, and 60.3% of the patients did not have macrometastasis in the sentinel lymph nodes.…”

“…Although 2 studies had shown that SLNB is feasible in T3/T4b patients with breast cancer, but none of them reported survival results after SLNB. 11 , 12 …”

Sentinel lymph node biopsy in patients with breast cancer ycT4N0M0 after neoadjuvant drug therapy

“…Вторая часть работы заключалась в анализе данных литературы, которые показали, что при размерах первичной опухоли, соответствующих Т3, частота N0-статуса составила 32,1 %, а при Т4b -61,0 %. Таким образом, авторы сделали вывод о том, что проведение БСЛУ может быть эффективным и помогает избежать излишней подмышечной лимфаденэктомии даже у пациентов с достаточно крупной первичной опухолью, классифицирующейся как Т3 или Т4b [11].…”