Dr. Naik on Surgical Approaches in Patients With Breast Cancer

Arpana M. Naik, MD, associate professor of surgery, Division of Surgical Oncology, School of Medicine, Oregeon Health and Science University, discusses surgical approaches in the treatment of patients with breast cancer.

The subject of whether a surgeon can safely do a sentinel lymph node biopsy after neoadjuvant chemotherapy in a patient who is known to have lymph node metastasis prior to starting chemotherapy is still being studied, says Naik. Physicians have positive information from 3 prospective multicenter trials that show that a sentinel lymph node biopsy is a feasible procedure. Some variations in technique will result in an acceptable false negative rate, says Naik.

The big question, she says, that remains is whether the change in procedure will have any impact on the local recurrence rate. In other words, physicians are still determining the long-term impact, if any, for the patient in terms of local control in their axilla.