1. 10 Years Experience and Analysis of Sentinel Lymph Node Biopsy in Wanfang Hospital
Wei Wen Chang, MD
Division of General Surgery, Department of Surgery,
Wan Fang Hospital, Taipei Medical University

2. Sentinel Lymph Node Biopsy (SLNB)
1993 Krag: 22 cases of SLNB with 99mTc
1994 Giuliano: 174 patients , SLNB, Blue dye
1996 Albertini: SLNB (Dual tracer)

3. Lancet Oncol Oct;11(10):

4. Materials and Methods 2006～2015
686 patients with female breast cancer (including DCIS)
Surgery first: 656
Neoadjuvant C/T (NAC/T) first: 30

5. Materials and Methods 丟西哇 The first SLNB in WFH : 2006
Dual tracer method in early period
Disease free survival (DFS) as the primary end point for validation our SLNB
丟西哇

6. Surgical Group (N =656) 項目 2006-2010 N(%) 2011-2015 Total 人數 247 409
年齡*
56.42
57.66 期別
21(8.5)
47(11.5) 68 1
63(25.5)
151(36.9)
214 2
105(42.5)
157(38.4)
262 3
53(21.5)
51(12.5)
106 4
5(2)
3(0.7) 8
乳房術式
全乳切除
216(87.4)
295(72.1)
511
乳房保留
31(12.6)
114(27.9)
145
腋下術式
SLNB (優先)
144(58.3)
372(91.0)
516
ALND (直接)
103(41.7)
37(9.0)
140
*平均值

7. SLNB (first) Patients 項目 2006-2010 N(%) 2011-2015 Total SLNB 144(27.9)
372(72.1)
516 期別
19(13.2)
47(12.6) 66 1
50(34.7)
151(40.6)
201 2
61(42.4)
145(39.0)
206 3
13(9.0)
28(7.5) 41 4
1(0.7)
1(0.3)
SLNB 檢查數*
3.89
3.06
SLN陽性數*
0.49
0.42
非SLN陽性數*
1.32
1.98
*平均值

8. Disease Free Survival (overall)
Cox Model, P>0.01

9. Stage Related DFS ( )
Cox Model, P <0.01

10. Stage Related DFS ( )
Cox Model, P < 0.01

11. Stage Related DFS (compared)

12. Validation of SLNB

13. DFS of pStage I (SLNB vs. ALND)
Events
Patients 2 43 1
143
LN dissection 3 28
Cox Model, P>0.01

14. DFS of pStage II (SLNB vs. ALND)
Events
Patients 6 36 3 70
LN 0-1 8
101
LN 2 33
LN 3 4 21
Cox Model, P>0.01

15. NAC/T Group (N=30) 2006-2010 2011-2015 Total 人數 6(20.0) 24(80.0) 30
臨床期別 2A
0(0)
1(4.2) 1 2B
2(33.3)
5(20.8) 7 3A
12(50.0) 14 3B 4
化療後期別
pCR 3 10 5 3C 2

16. NAC/T Group (con.) 2006-2010 N 2011-2015 Total Response ypT0 3 ypT1 9
ypT1 9 12
others 15
ypN0 6 18
ypN1 5 7
乳房術式
全乳切除 22 27
乳房保留 1 2
腋下術式
SLNB 8
ALND 4

17. PFS (Post NAC/T SLNB vs. ALND)
Cox Model, P>0.01

18. ypN0 vs. ypN1 vs. ypN2-3
Cox Model, P>0.01

19. DFS stage III (Post NAC/T vs. Surgery )
Cox Model, P>0.01

20. Discussion Little case numbers The overall DFS keeps improving
No difference of DFS between SLNB and ALND group in patients with pstage I & II breast cancer
Post-NAC/T SLNB is feasible
Neoadjuvant C/T seems would obtained better outcome for stage III patients