False-negative rate for sentinel nodes high after neoadjuvant chemotherapy

"[T]he appropriateness of SLN biopsy in this setting remains uncertain," although the study provides important information, according to Dr. Monica Morrow and Dr. Chau Dang. The increasing number of targeted therapies for breast cancer has enabled physicians to "move away from the ‘one size fits all’ approach." As a result, "the prognostic information obtained from residual nodal disease after neoadjuvant therapy is likely to become increasingly important in determining the need for additional therapy." If true, "research in ways to improve the performance of the SLN biopsy after neoadjuvant therapy is needed for this approach to become a viable management strategy."

Dr. Morrow and Dr. Dang of Memorial Sloan-Kettering Cancer Center in New York made their remarks in an editorial accompanying the article (JAMA 2013 Oct. 7 [doi:10.l001/jama.2013.7844]). Dr. Dang disclosed having received grant funding from Genentech. Dr. Morrow said she had no relevant financial disclosures.