# The use of blue dye alone for sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initially node-positive breast cancer.

**Autores:** Cavalcante Francisco Pimentel, Zerwes Felipe Pereira, Souza Alessandra Borba Anton et al
**Revista:** Eur J Surg Oncol (2024)
**PMID:** 38262300 | **PMCID:** —
**DOI:** [10.1016/j.ejso.2024.107967](https://doi.org/10.1016/j.ejso.2024.107967)
**Fuente:** PubMed (abstract only — full text vía DOI)

## Relevancia
Estudio retrospectivo (N=119) sobre conversión nodal post-NAC. Aborda tasa de falsos negativos del SLNB tras NAC.

## Abstract
False-negative sentinel lymph node biopsy (SLNB) rates following neoadjuvant chemotherapy (NACT) in initially node-positive (cN1/2) breast cancer patients are high, but decrease when lymph nodes are clipped, ≥3 sentinel lymph nodes (SLN) are removed or dual-tracer localization (radioisotope and blue dye) is used. Radiotracer, however, is often unavailable and outcomes with blue dye alone are unknown.

Initially cT1-4, cN1/2 patients treated with NACT in 2013-2023 who underwent SLNB using blue dye alone were evaluated regarding SLN identification, axillary recurrence, disease-free and overall survival rates.

Of 119 patients included, 19 remained cN1/2 after NACT. SLNB was performed using blue dye alone in 100 ycN0 cases (84%), with an identification rate of 96%. The SLN was negative in 70/119 cases (i.e. 59% avoided axillary dissection). The number of SLN detected was ≥3 in 55/70 cases (78%) (median 3.1; 1-6). Median age was 49 years (25-84). Most were T2 (n = 40, 57.1%), N1 (n = 64, 91.4%). Predominant subtypes were ERBB2 (52.9%) and triple-negative (20%). No axillary recurrence occurred over a median 36-month period. Five-year disease-free and overall survival were, respectively, 85.9% (95%CI: 74-99.8) and 96.3% (95%CI: 89.4-100). The ERBB2 subtype (1.99, 95%CI: 1.02-3.85, p = 0.04) and N1 lymph node status (2.58, 95%CI: 1.54-9.10, p = 0.03) were associated with a greater likelihood of undergoing SLNB alone without axillary dissection.

SLNB with blue dye alone following NACT in initially cN1/2 patients avoided axillary dissection in almost 60% of cases, with no recurrences during the period evaluated. Longer follow-up studies are necessary.

## Acceso
Artículo no disponible en PMC. Acceder vía [DOI](https://doi.org/10.1016/j.ejso.2024.107967) o suscripción institucional.

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*Datos de PubMed. Citar: doi 10.1016/j.ejso.2024.107967*
