Sentinel Lymph Node Surgery After Neoadjuvant Chemotherapy in Patients With Node-Positive Breast CancerThe ACOSOG Z1071 (Alliance) Clinical Trial
According to the Z1071 study, for patients who had positive nodes pre-chemotherapy and then had a sentinel node biopsy, the false-positive rate was less than 10% if dual tracer was used, greater than two sentinel nodes were removed, and any clipped nodes were included.
If only one lymph node was removed, the false-negative rate was unacceptably high and further axillary surgery was needed. Until the Alliance 11202 trial is completed, the standard treatment remains an axillary dissection for positive nodes after chemotherapy.
Boughey JC, Suman VJ, Mittendorf EA, et al. Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: The ACOSOG Z1071 (Alliance) Clinical Trial. JAMA. 2013; 310(14): 1455-1461. doi: 10.1001/jama.2013.278932.