Does Lymph Node Status Prior to Neoadjuvant Chemotherapy Influence the Number of Sentinel Nodes Removed?
Adult
Aged
Aged, 80 and over
Axilla
Breast Neoplasms
/ pathology
Carcinoma, Ductal, Breast
/ pathology
Carcinoma, Lobular
/ pathology
Female
Follow-Up Studies
Humans
Lymph Node Excision
Middle Aged
Neoadjuvant Therapy
Prognosis
Prospective Studies
Sentinel Lymph Node
/ pathology
Sentinel Lymph Node Biopsy
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
20
07
2018
pubmed:
7
12
2018
medline:
21
5
2019
entrez:
4
12
2018
Statut:
ppublish
Résumé
Recent prospective trials support the use of sentinel lymph node biopsy (SLNB) in breast cancer patients after neoadjuvant chemotherapy (NAC) with a lower false-negative rate if three or more sentinel lymph nodes (SLNs) are identified. In this study, we investigated whether the pre-NAC axillary lymph node status influences the number of SLNs identified. Stage I-III breast cancer patients who received NAC and underwent SLNB from May 2014 to April 2016 were identified from an institutional prospective database. Clinical and pathological factors among clinically node-negative (cN-) and clinically node-positive (cN+) patients who converted to cN- post-NAC were compared. Generalized linear mixed models analyzed factors associated with the number of SLNs removed. Among 343 patients who underwent SLNB during the study period, 335 (98%) had at least one SLN identified, and subsequently comprised the study population. The median number of SLNs identified was 4 (range 1-14), which did not differ according to pre-NAC nodal status (P = 0.15). Overall, 85% of patients had three or more SLNs identified (80% cN- group vs. 89% cN+ group; P = 0.02). On univariable analysis, age < 50 years and presenting with a positive axillary node were significantly associated with identifying three or more SLNs. Our study confirms that SLNB was successfully performed in 98% of our patients after NAC, with very few failed mapping procedures. In the post-NAC setting, the median number of SLNs identified was four, and the status of the axilla prior to NAC did not negatively affect the number of SLNs identified.
Sections du résumé
BACKGROUND/OBJECTIVE
OBJECTIVE
Recent prospective trials support the use of sentinel lymph node biopsy (SLNB) in breast cancer patients after neoadjuvant chemotherapy (NAC) with a lower false-negative rate if three or more sentinel lymph nodes (SLNs) are identified. In this study, we investigated whether the pre-NAC axillary lymph node status influences the number of SLNs identified.
METHODS
METHODS
Stage I-III breast cancer patients who received NAC and underwent SLNB from May 2014 to April 2016 were identified from an institutional prospective database. Clinical and pathological factors among clinically node-negative (cN-) and clinically node-positive (cN+) patients who converted to cN- post-NAC were compared. Generalized linear mixed models analyzed factors associated with the number of SLNs removed.
RESULTS
RESULTS
Among 343 patients who underwent SLNB during the study period, 335 (98%) had at least one SLN identified, and subsequently comprised the study population. The median number of SLNs identified was 4 (range 1-14), which did not differ according to pre-NAC nodal status (P = 0.15). Overall, 85% of patients had three or more SLNs identified (80% cN- group vs. 89% cN+ group; P = 0.02). On univariable analysis, age < 50 years and presenting with a positive axillary node were significantly associated with identifying three or more SLNs.
CONCLUSIONS
CONCLUSIONS
Our study confirms that SLNB was successfully performed in 98% of our patients after NAC, with very few failed mapping procedures. In the post-NAC setting, the median number of SLNs identified was four, and the status of the axilla prior to NAC did not negatively affect the number of SLNs identified.
Identifiants
pubmed: 30506175
doi: 10.1245/s10434-018-7004-6
pii: 10.1245/s10434-018-7004-6
pmc: PMC6342628
mid: NIHMS1515496
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
336-342Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NIH/NCI Cancer Center Support Grant
ID : P30 CA008748
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