Sentinel Lymph Node Surgery after Neoadjuvant Chemotherapy in Breast Cancer

Rodrigo Arrangoiz MS, MD, FACS, FSSO

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  • Retrospective studies of sentinel lymph node (SLN) biopsy validated by axillary lymph node dissection (ALND) show that the success rate of SLN biopsy after neoadjuvant chemotherapy is about:
    • 90%:
      • Somewhat less than for SLN biopsy overall:
        • The false-negative rate is about 10%:
          • Comparable to SLN biopsy overall
  • For patients with proven nodal metastases:
    • The prospective American College of Surgeons Oncology Group (ACOSOG) Z1071 and SENTinel NeoAdjuvant (SENTINA) trials observe success rates of:
      • 85% to 90%:
        • False-negative rates of 12% to 14% for SLN biopsy.
      • In both studies the false-negative rate was minimized by dual-agent mapping (dye plus isotope) and the removal of greater than two SLN:
        • These results suggest that ALND may not be required for node-positive patients postchemotherapy when a technically satisfactory SLN biopsy is negative.
        • Patients with any positive axillary nodes postchemotherapy require ALND and are at increased risk of locoregional recurrence.
          • A new trial:
            • Alliance 11202 is randomizing node-positive patients whose SLN remain positive after neoadjuvant chemotherapy to ALND / RT versus RT alone.

Rodrigo Arrangoiz MS, MD, FACS cirujano oncology y miembro de Sociedad Quirúrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

  • Es experto en el manejo del cáncer de mama.

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Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

#Arrangoiz

#Surgeon

#Cirujano

#SurgicalOncologist

#CirujanoOncologo

#BreastSurgeon

#CirujanodeMama

#CancerSurgeon

#CirujanodeCancer

http://www.sociedadquirurigca.com

 

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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