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Theses

Le ganglion sentinelle post chimiothérapie

Abstract : In breast cancer, neoadjuvant chemotherapy (NAC) have allowed more conservatrive surgical treatment. While sentinel lymph node (SLN) biopsy is not recommanded after NAC, we have demonstrated faisability of these procedure in a prospective study of 129 patients trated by NAC : identification rate was 93.8% and false negative rate was 14.3% and 0% for N0 patients before NAC. Tumoral size (p=0.016), SLNB macro metastases (p=0.0055) were correlated with non SLN metastases when SLN was positive. MD Anderson nomogram (AUC=0.716) and Thenon scoring system (AUC=0.778) were validated topredict the probability of non SLN metastases. SLN metastases were correctly identified using imprint cytology (IC) in 72% of patients. patients with micro metastases or isolated tumor cell in SLN have 2.3 times higher risk of a false negative IC result than patient with macro metastases. Conclusion : we have demonstrated that NAC does not seem to influence accuracy of SLN procedure especially for N0 patients before NAC. After NAC, IC is feasable and the risk of involvement of non SLN when the SLN is metastatic may be assessed using existing nomograms.
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Submitted on : Friday, July 20, 2012 - 12:19:36 PM
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  • HAL Id : tel-00719621, version 1

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Pierre Gimbergues. Le ganglion sentinelle post chimiothérapie. Cancer. Université d'Auvergne - Clermont-Ferrand I; Université Blaise Pascal - Clermont-Ferrand II, 2010. Français. ⟨NNT : 2010CLF1MM29⟩. ⟨tel-00719621⟩

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