Aim 1: Identify the pathological result of SLN and ALN
Hypothesis:
The lymph node containing the clip placed at percutaneous biopsy before chemotherapy was found at surgery to be one of the SLNs
Method:
This study is a prospective study. 30 patients who will undergo neoadjuvant chemotherapy were asked to participate in this study. Informed consent will be given. Clip will be placed over the positive lymph node by surgeon which was proven by fine-needle aspiration cytology. After completion of neoadjuvant chemotherapy, surgery of the breast and the axilla was executed in the same session. Different surgeons performed the procedure.
The SLNB will be performed by dual tracer (blue dye plus indocyanine green or radioisotope). After remove the SLNs and ALN, detection of the clipped node will be identified under mammography-guided. The clipped lymph node will be marked separately. All of the lymph node will be sent to pathologist for final examination.
Aim 2: Check the feasibility of SLNB after neoadjuvant CT
Hypothesis:
SLNB is feasible after neoadjuvant CT under certain circumstances.
Method:
The primary endpoints used for statistical analysis were the success rate for identifying and selectively removing the clipped node and the correlation of the response observed in the clipped node on pathology with the ALND specimen. The identification rate of the clipped node was analyzed in all patients who underwent surgical removal of the clipped node. Correlation between the pathologic response observed in the clipped node and in the ALND specimen was estimated using false-negative rates, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.
