Neoadjuvant chemotherapy and sentinel lymph node in breast cancer
Research type
Research Study
Full title
Accuracy of the sentinel node in assessing the axilla after neoadjuvant chemotherapy for breast cancer
IRAS ID
161198
Contact name
Maged Hussien
Contact email
Sponsor organisation
Norfolk and Norwich University Hospital NHS Trust
Research summary
Breast cancer is a common condition among women in the UK. Breast cancer usually develops in the breast initially prior to spreading to the lymph glands in the axilla (armpit) and then elsewhere in the body. Surgical treatment involves removing the breast cancer as well as removing the glands from the axilla. Breast cancer spreads to the "sentinel node" first before moving to glands higher in the axilla. Surgery in the axilla can lead to debilitating conditions such as lymphoedema (swelling and fluid retention in the arm) and difficulty using the hand or arm on that side. If the sentinel node is biopsied and does not contain any tumour cells, it is likely that the remainder of the glands are clear of tumour cells and can be safely left in-situ, minimising the amount of axillary surgery and thus the adverse consequences.
Sometimes it is necessary to shrink down ("downstage") the breast cancer prior to surgery using chemotherapy (neoadjuvant chemotherapy), a systemic treatment which can potentially also affect the tumour cells in the nodes of the axilla. However, controversy exists over the accuracy and sensitivity of the sentinel node assessment in this setting.
This study aims to determine whether it is safe to use sentinel node biopsy to predict axillary node involvement after neoadjuvant chemotherapy. Thus, enabling the adjustment of surgical treatment if downstaging of the axilla occurs avoiding extensive axillary surgery with the benefit of avoiding the complications such as lymphoedema.REC name
East of England - Cambridge South Research Ethics Committee
REC reference
14/EE/1139
Date of REC Opinion
18 Nov 2014
REC opinion
Further Information Favourable Opinion