Sensitivity and specificity of axillary sentinel lymph node after neoadjuvant chemotherapy in advanced breast cancer
Keywords:
Sensitivity and specificity., Breast neoplasias, Sentinel lymph node biopsyAbstract
Objective: To evaluate the agreement of histopathologic findings on sentinel and axillary lymph nodes
after neoadjuvant chemotherapy for advanced breast cancer. Methods: Within a prospective, clinical
study, lymph node groups of 21 women, carriers of breast cancer in stadium III or IV, submitted to neoadjuvant chemotherapy and radical mastectomy after lymph node biopsy by patent blue, at the Hospital
Universitário Oswaldo Cruz, Recife, Pernambuco, Brazil, from October 2005 to October 2006, were
histopathologically compared. Statistical Package for Social Sciences 13.0 software was used to perform
Fisher exact test, with significance level of 5%, Kappa test and calculi of agreement, sensibility, specificity, positive and negative predictive values, false negatives and positives ratios. One excluded 7/28
(25%) patients due to the impossibility to identify sentinel lymph node. Results: Excised sentinel lymphnodes varied from one (19/21; 90.5% patients) to two (2/21; 9.5% ofpatients). Comparing sentinel to
axillary lymph nodes forpositivity of neoplasic cells, rates of agreement, false negatives and positives, sensibility and specificity were: 71.4%, 38.5%, 12.5%, 61.5% and 87.5%, respectively, with significant
concordance degree (p = 0.027; к = 0.447). Conclusion: Related to other studies, one identified minor
concordance rate, higherfalse negative rate and equal identification rate, associated to low sensibility,
high specificity and a significant concordance degree.
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