Objective To explore the tumor shrinking model, the accurate image evaluation of the residual tumor, and the selection criteria for breast-conserving surgery after neoadjuvant chemotherapy. Methods To review literature on the clinical, imaging, and pathologic study of breast cancer after neoadjuvant chemotherapy. Results The possibility of breast-conserving for patients with large primary tumor is enhanced with neoadjuvant chemotherapy. The tumor shrinking mode after neoadjuvant chemotherapy and its correlation factors are still unclear. MRI is the most accurate image evaluation of the residual tumor at present. M.D.Anderson prognostic index and the American National Cancer Institute selection criteria for breast-conserving surgery after neoadjuvant chemotherapy are helpful for selection of surgical type. Conclusion Tumor shrinking mode and its accurate image evaluation is a key to the selection of breast-conserving surgery and the control of local recurrence after neoadjuvant chemotherapy, and is the research direction in future.
ObjectiveTo evaluate the quality of life after sentinel lymph node biopsy (SLNB) in patients with breast cancer. MethodsFrom January 2004 to December 2006, 591 patients with breast cancer who were suitable for SLNB were divided into SLNB group (n=339) and axillary lymph node dissection (ALND) group (n=252). All patients didn’t have the upper extremity joints disease, the vascular nerve disease, and the cervical spondylosis previously. Results①In patients with SLNB, the circumferences of upper arm in one, two, and three weeks after operation were similar to those before operation (P=0.232, P=0.318, and P=0.415, respectively). While, in patients with ALND, the circumferences of upper arm in one or two weeks after operation were significantly bigger than those before operation (P=0.011, P=0.041, respectively), and the circumference in three weeks after operation was similar to that before operation (P=0.290). ②In patients with SLNB, the outreach angles of shoulder joint in one and two weeks after operation were significantly smaller than those before operation (P=0.031, P=0.043, respectively), and the angle in three weeks after operation was similar to that before operation (P=0.196). However, in patients with ALND, the angles in one, two or three weeks after operation were significantly smaller than those before operation (all Plt;0.001). ③The retention time of drainage tube in patients with ALND who received breast conserving surgery or mastectomy was significantly longer than that in patients with SLNB who received mastectomy (all Plt;0.001). ④The infection rate and the sensory disjunction rate in patients with ALND were significantly higher than those in patients with SLNB (P=0.002, Plt;0.001, respectively). ConclusionsFor patients with lymph node negative breast cancer, SLNB could decrease postoperative complications, and improve the quality of life. It could also save money by reducing hospital stay.