Sentinel Lymph Node Biopsy for Breast Cancer

This trial targets individuals with inflammatory breast cancer (IBC) and aims to determine the safety of sampling underarm lymph nodes during surgery. Participants will undergo a sentinel lymph node biopsy, which removes a few key lymph nodes, and a full axillary lymph node dissection, which removes more lymph nodes in the underarm, during their planned surgery. This trial suits those diagnosed with IBC who have completed chemotherapy before surgery and are having their surgery at the Cleveland Clinic. As an unphased trial, it offers participants the chance to contribute to significant surgical research that could enhance future treatment options.

Research has shown that a sentinel lymph node biopsy (SLNB) is generally safe and less invasive than a full axillary lymph node dissection, which involves more extensive surgery. Although SLNB can cause side effects such as swelling (lymphedema) and an increased risk of infection in the area, serious reactions are rare. Some patients experience brief pain during the procedure. Overall, SLNB results in fewer complications compared to more extensive breast cancer surgeries.¹²³⁴⁵

Sentinel Lymph Node Biopsy is unique because it focuses on identifying the first few lymph nodes into which a tumor drains, called sentinel nodes, to determine the extent of breast cancer spread. Unlike traditional methods that may involve removing many lymph nodes, this technique targets only the most critical ones, potentially reducing surgery-related side effects like lymphedema and pain. Researchers are excited about this approach because it provides more precise staging information and may lead to more personalized and less invasive treatment plans for patients with inflammatory breast cancer.

Research has shown that sentinel lymph node biopsy (SLNB) often doesn't work well for most patients with inflammatory breast cancer (IBC). One study found that only a small group of patients, specifically those who respond completely to initial treatment, might successfully undergo SLNB. In early-stage breast cancer, SLNB has helped detect cancer spread, improving the chances of remaining cancer-free for some patients. However, current evidence suggests that SLNB is not widely recommended for IBC due to insufficient proof of its effectiveness. Although the use of SLNB is increasing, it often doesn't replace the need for a full removal of axillary lymph nodes (ALND) in IBC cases. This trial will evaluate the effectiveness of SLNB specifically for those diagnosed with IBC.¹²⁵⁶⁷