Sentinel lymph node biopsy after chemotherapy

The timing of sentinel lymph node (SLN) biopsy in patients receiving neoadjuvant chemotherapy remains a debated topic, despite increasing literature supporting use of SLN biopsy after chemotherapy. This article outlines the arguments for SLN biopsy prior to initiation of systemic therapy versus after neoadjuvant chemotherapy and the literature surrounding this debate. Additionally, special patient populations, including patients with inflammatory breast cancer and those presenting with node-positive disease, are discussed. SLN biopsy after completion of chemotherapy is accurate for axillary staging of patients with clinically node-negative axillas at presentation, except for those with inflammatory breast cancer.