Question: Is sentinel lymph node biopsy accurate if I have had chemotherapy before surgery?
Answer: Sentinel lymph node biopsy is just as accurate for late-stage breast cancer as it is for early-stage breast cancer. So if you've had neoadjuvant chemotherapy, our success rate in finding the sentinel node is very similar to that when we look for it in early-stage breast cancer. However, there are some exceptions. For patients who still have persistent disease in the axilla -- in other words, you think that there are still positive nodes there -- we would not recommend a sentinel node mapping in that situation but would perform the standard axillary node dissection. Also, for very large tumors that do not shrink with the chemotherapy, we think it's best for those patients also to have a standard axillary node dissection.