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• W4309487777 abstract "Background: Some studies have suggested that the patients included in the Z0011 trial may have represented only patients with ultrasound-negative axillary nodes and axillary invasion diagnosed by sentinel node biopsy. Nevertheless, the NCCN guidelines recommend sentinel node mapping if 1 or 2 suspicious lymph nodes are identified on axillary ultrasound. The aim of this preliminary phase of the MUTAS trial was therefore to establish the accuracy of sentinel node mapping in patients with axillary involvement undergoing upfront surgery. Material and methods: We recruited patients with proven metastatic axillary nodes and upfront surgery. We performed sentinel node mapping in these patients before the surgical intervention. During the intervention, the biopsy-proven metastatic node, sentinel nodes and the remaining axillary nodes were excised and identified separately. Sentinel node status was considered representative of the status of the remaining axillary nodes. We calculated the sensitivity, specificity, negative predictive value and positive predictive value of the sentinel node, overall and in patients with palpable nodes, in those with non-palpable nodes and an ultrasound diagnosis of axillary involvement, in those with 1 or 2 suspicious nodes on axillary ultrasound, and in patients with a single suspicious node on axillary ultrasound. Results: We included 25 patients in this preliminary phase. The false-negative rate of sentinel node mapping was 28% overall, 21.42% for patients with palpable nodes, 36.36% for patients with non-palpable nodes and an ultrasound diagnosis of axillary involvement, 28.75% for those with 1 or 2 suspicious nodes on axillary ultrasound, and 15.38% in patients with a single suspicious node on axillary ultrasound. Negative predictive value was highest in patients with a single suspicious node on axillary ultrasound (75%). Conclusion: In this study, sentinel node mapping was not reliable in patients with biopsy-proven metastatic axillary nodes and upfront surgery, either overall or for any of the subgroups studied, as the false negative rate was above 10%. Consequently, it is doubtful that the sentinel node adds any valid information in patients with 1 or 2 suspicious axillary lymph nodes on ultrasound, even if lymph nodes are non-palpable. NCCN recommendations regarding these patients seem inadequate from our point of view. This study was funded by the 6th Ana Balil Grant of the GEICAM (Spanish acronym for the Grupo Español de Investigación en Cáncer de Mama [Spanish Breast Cancer Group]). No conflict of interest." @default.
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• W4309487777 date "2022-11-01" @default.
• W4309487777 modified "2023-09-27" @default.
• W4309487777 title "Sentinel node mapping in patients with biopsy-proven metastatic axillary lymph nodes and upfront surgery: preliminary results of the Multimodal Targeted Axillary Surgery (MUTAS) trial" @default.
• W4309487777 doi "https://doi.org/10.1016/s0959-8049(22)01386-7" @default.
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