Research

QBCF Strategic Grants Program

Research Factsheet

DR. JEAN-FRANÇOIS BOILEAU

CENTRE HOSPITALIER DE L’UNIVERSITÉ DE MONTRÉAL, MONTRÉAL

PROJECT TITLE

Sentinel node biopsy following neoadjuvant chemotherapy in biopsy

proven node positive patients

PRINCIPAL INVESTIGATOR Dr. Jean-Francois Boileau, MD, MSc, Surgical Oncologist and Assistant

Professor

INSTITUTE Centre hospitalier de l’Université de Montréal, Montréal

CO-APPLICANTS

Ginette Martin, Université de Montréal • Erica Patocskai, Université

de Montréal • Sarkis Meterissian, McGill University • Brigitte Poirier,

Université Laval • Lucas Sidéris, Université de Montréal • Andre

Robidoux, Université de Montréal

TOTAL RESEARCH BUDGET $424,500

RESEARCH SUMMARY*:

For some women with breast cancer, it is preferable to give chemotherapy before undergoing surgery. Sometimes, chemotherapy can completely clear all traces of breast cancer in the breast and in the axilla. With current chemotherapy regimens, 4 people out of 10 that present with disease in their lymph nodes are expected to undergo a complete response in the axilla. At surgery, these women will probably be offered to undergo a complete removal of the nodes in the axilla, with a substantial risk of arm swelling, nerve damage (mostly sensitive) and infection.

If it was possible to accurately identify who has had a complete response in their axilla without having to submit everyone to an axillary node dissection, we could spare the unnecessary morbidity of this procedure to these people. We can test for the presence

of microscopic disease in the lymph nodes by removing only the first nodes (usually 1 to 4 nodes) that drain the affected breast and leave the rest of the nodes in place (sentinel node biopsy).

The problem is that we do not know if this procedure can accurately predict who has had a complete clearance of the cancer cells in the lymph nodes following chemotherapy.

Previous studies, with a relatively small number of patients, have obtained large variations in accuracy. To verify this, 4 cancer centers in the province of Quebec will recruit a large number of women with breast cancer that has spread to the lymph nodes that decide to receive chemotherapy before surgery. We will offer to perform a sentinel node biopsy as well as a complete clearance of the lymph nodes - which is the current standard practice - to everyone. If sentinel node biopsy is proven to be accurate in this situation, then we can hope to lower the morbidity of breast cancer treatment in an increasing number of breast cancer patients.

* This document is a non-scientific summary.