Evaluation Of Lymph Nodes After Neoadjuvant Chemotherapy
Evaluation Of Lymph Nodes After Neoadjuvant Chemotherapy
This research protocol is studying the accuracy of the sentinel lymph node biopsy procedure
 in breast cancer patients who have cancer cells in the lymph nodes in the armpit (axilla) who
 have received chemotherapy or endocrine therapy prior to having surgery (neoadjuvant
 therapy).
-  This research study is a Pilot Study, which is the first time investigators are
 examining this study intervention locally; although this intervention has been studied
 nationally in published clinical trials.

 -  In this research study, the investigators are studying the accuracy of the sentinel
 lymph node biopsy procedure in breast cancer patients who have cancer cells in the lymph
 nodes in the armpit (axilla) who have received chemotherapy or endocrine therapy prior
 to having surgery (neoadjuvant therapy).

 -  A sentinel lymph node biopsy is a surgical evaluation of the lymph nodes in the underarm
 area in patients who have early breast cancer. Approximately, two-five nodes are removed
 from the underarm area for evaluation. The sentinel lymph node biopsy is performed in
 patients with breast cancer to determine if there are cancer cells in the lymph nodes in
 the armpit.

 -  The sentinel lymph node biopsy procedure is performed by injecting one or two dyes into
 the breast, which then travel to the armpit region via small vessels in the immune
 system. These nodes are called the sentinel lymph nodes. They represent the first nodes
 that drain the breast tissue. They are closely evaluated by a Pathologist to determine
 if cancer cells are present.

 -  This information allows physicians to know how far the cancer may have spread and
 recommend therapies accordingly.

 -  If sentinel lymph node biopsy is determined to be accurate in patients who are known to
 already have cancer cells in the axillary lymph nodes who receive neoadjuvant therapy,
 then in the future, many of the patients in this population may be spared the procedure
 of a full axillary lymph node dissection, which removes a larger number of lymph nodes
 and thus has increased risks and side-effects.
Inclusion Criteria:

 -  Eligible patients will include any patients with biopsy-proven breast cancer and
 biopsy-proven axillary lymph node metastases at Beth Israel Deaconess Medical Center
 who are candidates for Neoadjuvant Chemotherapy or Neoadjuvant Endocrine therapy.

 -  A core needle biopsy or fine needle aspiration is acceptable for diagnosis of
 metastatic disease in lymph nodes.

 -  Patients will be identified as possible participants in the Radiology Imaging suites
 and Breast Surgery Clinics.

 Exclusion Criteria:

 -Patients with inflammatory breast cancer or distant metastases will be excluded from
 participating in this study