الفهرس 
INTRODUCTION AND AIM OF WORKOnly 14 pages are availabe for public view
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Abstract
Given the advances in the efficiency of NACT in reducing the size of the primary breast cancer (to the extent of complete gross/ microscopic resolution in some cases, it is logical to assume the same response in the axilla.
This prospective study included 93 female patients with locally advanced breast cancer (LABC) previously treated with neoadjuvant chemotherapy with clinically negative axillary lymph nodes. True cut biopsy of the primary breast tumor and FNAC of ALNs were performed before NACT. This was followed by surgical local control started with SLNB using dye injection then ALND was done in all patients followed by mastectomy procedure as dictated by each patient’s condition.SLN mapping and identification was unsuccessful in 9 patients. Primary tumor, SLNB, ALND specimens were submitted for pathological examination
Authors propose is to assess the feasibility and accuracy of sentinel lymph node biopsy detection for female patients with locally advanced breast cancer after neoadjuvant chemotherapy.
Results:
Considering pathological result of ALND as the gold standard:
Ultrasonography was found to be accurate to confirm clinical examination in the assessment of ALNs response post NACT and SLNB was found to be weak in predicting pathological nodal response with Sensitivity, specificity, PPV, NPV and accuracy; of 63.2%, 36.4% 63.2%, 36.4%,53.3% respectively.(P.value 0.979). The identification rate of SLN was 76.9% with a false negative rate of 26.9%.
Summary
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Authors concluded that Combination Ultrasonography, clinical examination only cannot assess and predict nodal response and SLNB is feasible after NACT with accepted identification(76.9%) rate but SLNB found not to accurate in predicting pathological nodal response post NACT.
Thus, the need for ALND cannot be obviated in certain percentage of Patient. It needs more clinical trials covering larger number of patients.