Study Evaluates Diagnostic Accuracy of Sentinel Lymph Node Biopsy and Wire Localized Clipped Node in Breast Cancer Patients

A prospective, single-center trial was conducted to explore the diagnostic accuracy of sentinel lymph node biopsy (SLNB) combined with wire localized lymph node biopsy (WLNB) of the clip-marked node as an axillary staging technique in patients with node-positive breast cancer after neoadjuvant chemotherapy (NACT). The study enrolled 233 patients, with 208 included in the final analysis. The findings showed that the identification rate (IR) for SLNB and WLNB alone were 63.0% and 70.7%, respectively. However, the IR for targeted axillary dissection (TAD) was significantly higher at 87.5%. The false-negative rate (FNR) and negative predictive value (NPV) for the TAD procedure were 6.9% (95% confidence interval [CI]:2.0-11.8%) and 92.0% (95% CI 86.3-97.7%), respectively. In comparison, the FNR and NPV for SLNB alone were 17.1% (95% CI 8.2-25.6%) and 83.3% (95% CI:74.7-91.9%), and for WLNB alone, they were 6.7% (95% CI:1.5-12.0%) and 90.6% (95% CI:83.5-97.7%). These results suggest that TAD, combining SLNB and WLNB, offers a more accurate method for axillary staging in this patient population.