Management of the axilla in postmenopausal patients with cN0 hormone receptor-positive/HER2-negative breast cancer treated with neoadjuvant endocrine therapy and its prognostic impact.
Axillary management
Axillary node dissection
De-escalation
Hormone-receptor-positive breast cancer
Neoadjuvant endocrine therapy
Sentinel lymph node biopsy
Journal
Breast cancer research and treatment
ISSN: 1573-7217
Titre abrégé: Breast Cancer Res Treat
Pays: Netherlands
ID NLM: 8111104
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
20
12
2022
accepted:
28
03
2023
medline:
15
5
2023
pubmed:
13
4
2023
entrez:
12
4
2023
Statut:
ppublish
Résumé
To evaluate the differences in nodal positivity if the sentinel lymph node biopsy (SLNB) is performed before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and its impact on prognosis. A retrospective cohort study was performed in a single center including 91 postmenopausal cases with clinically node-negative and hormone receptor-positive/HER2-negative (HR + /HER2-) breast cancer, treated with NET and SLNB. SLNB was done pre-NET until 2014, and post-NET thereafter. Axillary lymph node dissection (ALND) was indicated only in SLNB macrometastasis, although in selected elderly patients, it was omitted. Kaplan-Meier survival curves were estimated in relation to the status of the axilla, and the differences assessed using the log-rank test. Between December 2006 and March 2022, SLNB was performed pre-NET in 14 cases and post-NET in 77. Both groups were similar in baseline tumor and patient characteristics. SLNB positivity was similar regardless of whether SLNB was performed before (5/14, 35.7%) or after NET (27/77, 37%), with 2/14 SLN macrometastases in the pre-NET cohort and 17/77 in the post-NET cohort. Only three patients (18.7%) with SLN macrometastasis had > 3 positive nodes following ALND. The 5-year overall survival and distant disease-free survival were 92.4% and 94.8%, respectively, with no significant differences according to SLNB status (p 0.5 and 0.8, respectively). SLN positivity did not differ according to its timing (before or after NET). Therefore, NET has no effect on lymph node clearance. Furthermore, the prognosis is good regardless of the axillary involvement. Therefore, factors other than axillary involvement may affect the prognosis in these patients.
Identifiants
pubmed: 37043108
doi: 10.1007/s10549-023-06926-y
pii: 10.1007/s10549-023-06926-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
445-456Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Burstein HJ (2020) Systemic therapy for estrogen receptor-positive, her2-negative breast cancer. N Engl J Med 383(26):2557–2570
doi: 10.1056/NEJMra1307118
pubmed: 33369357
Waks AG, Winer EP (2019) Breast cancer treatment: a review. JAMA: J Am Med Assoc Am Med Assoc 321:288–300
doi: 10.1001/jama.2018.19323
Gianni L, Baselga J, Eiermann W, Porta VG, Semiglazov V, Lluch A et al (2005) Feasibility and tolerability of sequential doxorubicin/paclitaxel followed by cyclophosphamide, methotrexate, and fluorouracil and its effects on tumor response as preoperative therapy. Clin Cancer Res 11(24):8715–8721
doi: 10.1158/1078-0432.CCR-05-0539
pubmed: 16361558
Rouzier R, Perou CM, Symmans WF, Ibrahim N, Cristofanilli M, Anderson K et al (2005) Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res 11(16):5678–5685
doi: 10.1158/1078-0432.CCR-04-2421
pubmed: 16115903
Sella T, Weiss A, Mittendorf EA, King TA, Pilewskie M, Giuliano AE et al (2021) Neoadjuvant endocrine therapy in clinical practice: a review. JAMA Oncol 7(11):1700–1708
doi: 10.1001/jamaoncol.2021.2132
pubmed: 34499101
Weiss A, King TA, Mittendorf EA (2020) The landmark series: neoadjuvant endocrine therapy for breast cancer. Ann Surg Oncol 27(9):3393–3401
doi: 10.1245/s10434-020-08530-6
pubmed: 32591951
Kuehn T, Bauerfeind I, Fehm T, Fleige B, Hausschild M, Helms G et al (2013) Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study. Lancet Oncol 14(7):609–618
doi: 10.1016/S1470-2045(13)70166-9
pubmed: 23683750
Schmid P, Cortes J, Pusztai L, McArthur H, Kümmel S, Bergh J et al (2020) Pembrolizumab for early triple-negative breast cancer. N Engl J Med 382(9):810–821
doi: 10.1056/NEJMoa1910549
pubmed: 32101663
Fernandez-Gonzalez S, Falo C, Pla MJ, Verdaguer P, Nuñez D, Guma A et al (2020) Predictive factors for omitting lymphadenectomy in patients with node-positive breast cancer treated with neo-adjuvant systemic therapy. Breast J 26(5):888–896
doi: 10.1111/tbj.13763
pubmed: 32052521
Stafford A, Williams A, Edmiston K, Cocilovo C, Cohen R, Bruce S et al (2020) Axillary response in patients undergoing neoadjuvant endocrine treatment for node-positive breast cancer: systematic literature review and NCDB analysis. Ann Surg Oncol 27(12):4669–4677
doi: 10.1245/s10434-020-08905-9
pubmed: 32909130
pmcid: 7480656
Fernandez-Gonzalez S, Falo C, Pla MJ, Pernas S, Bajen M, Soler T et al (2018) The shift from sentinel lymph node biopsy performed either before or after neoadjuvant systemic therapy in the clinical negative nodes of breast cancer patients. Results and the advantages and disadvantages of both procedures. Clin Breast Cancer 18:71–7
doi: 10.1016/j.clbc.2017.08.014
pubmed: 29030106
Rudenstam CM, Zahrieh D, Forbes JF, Crivellari D, Holmberg SB, Rey P et al (2006) Randomized trial comparing axillary clearance versus no axillary clearance in older patients with breast cancer: first results of International Breast Cancer Study Group trial 10–93. J Clin Oncol 24(3):337–344
doi: 10.1200/JCO.2005.01.5784
pubmed: 16344321
Weiss A, Wong S, Golshan M, Freedman RA, Metzger O, Bellon J et al (2019) Patterns of axillary management in stages 2 and 3 hormone receptor-positive breast cancer by initial treatment approach. Ann Surg Oncol 26(13):4326–4336
doi: 10.1245/s10434-019-07785-y
pubmed: 31562601
Martínez-Pérez C, Turnbull AK, Kay C, Dixon JM (2023) Neoadjuvant endocrine therapy in postmenopausal women with HR+/HER2− breast cancer. Expert Rev Anticancer Ther 23(1):67–86
doi: 10.1080/14737140.2023.2162043
pubmed: 36633402
Barchiesi G, Mazzotta M, Krasniqi E, Pizzuti L, Marinelli D, Capomolla E et al (2020) Neoadjuvant endocrine therapy in breast cancer: current knowledge and future perspectives. Int J Mol Sci 21(10):1–23
doi: 10.3390/ijms21103528
Chia YH, Ellis MJ, Ma CX (2010) Neoadjuvant endocrine therapy in primary breast cancer: indications and use as a research tool. Br J Cancer 103(6):759–764
doi: 10.1038/sj.bjc.6605845
pubmed: 20700118
pmcid: 2966629
Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thürlimann B et al (2013) Personalizing the treatment of women with early breast cancer: highlights of the St Gallen international expert consensus on the primary therapy of early breast cancer 2013. Ann Oncol 24(9):2206–23
doi: 10.1093/annonc/mdt303
pubmed: 23917950
pmcid: 3755334
Tirkes T, Hollar MA, Tann M, Kohli MD, Akisik F, Sandrasegaran K (2013) Response criteria in oncologic imaging: review of traditional and new criteria. Radiographics 33(5):1323–1341
doi: 10.1148/rg.335125214
pubmed: 24025927
Murphy BM, Hoskin TL, Degnim AC, Boughey JC, Hieken TJ (2021) Surgical management of axilla following neoadjuvant endocrine therapy. Ann Surg Oncol 28(13):8729–8739
doi: 10.1245/s10434-021-10385-4
pubmed: 34275042
pmcid: 8286162
Friedman-Eldar O, Ozmen T, El Haddi SJ, Goel N, Tjendra Y, Kesmodel SB et al (2022) Axillary response to neoadjuvant therapy in node-positive estrogen receptor-positive, human epidermal growth factor receptor 2-negative breast cancer patients: predictors and oncologic outcomes. Ann Surg Oncol 29:4092
doi: 10.1245/s10434-022-11473-9
Kantor O, Wakeman M, Weiss A, Wong S, Laws A, Grossmith S et al (2021) Axillary management after neoadjuvant endocrine therapy for hormone receptor-positive breast cancer. Ann Surg Oncol 28(3):1358–1367
doi: 10.1245/s10434-020-09073-6
pubmed: 32869154
Kantor O, Wong S, Weiss A, Metzger O, Mittendorf EA, King TA et al (2020) Prognostic significance of residual nodal disease after neoadjuvant endocrine therapy for hormone receptor-positive breast cancer. npj Breast Cancer. https://doi.org/10.1038/s41523-020-00177-6
doi: 10.1038/s41523-020-00177-6
pubmed: 32821803
pmcid: 7426953
Fisher B, Jeong J, Anderson S (2002) Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. New Engl J Med Engl J 347(8):567–75
doi: 10.1056/NEJMoa020128
Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW et al (2011) Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA: J Am Med Assoc 305(6):569–575
doi: 10.1001/jama.2011.90
Giuliano AE, Ballman KV, McCall L, Beitsch PD, Brennan MB, Kelemen PR et al (2017) Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (Alliance) randomized clinical trial. JAMA: J Am Med Assoc 318(10):918–926
doi: 10.1001/jama.2017.11470
Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJH, Mansel RE et al (2014) Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981–22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 15(12):1303–1310
doi: 10.1016/S1470-2045(14)70460-7
pubmed: 25439688
pmcid: 4291166
Bartels SAL, Donker M, Poncet C, Sauv N, Straver ME, Mansel RE et al (2022) Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer: 10-year results of the randomized controlled EORTC 10981–22023 AMAROS trial. J Clin Oncol. https://doi.org/10.1200/JCO.22.01565
doi: 10.1200/JCO.22.01565
pubmed: 36383926
Nitz UA, Gluz O, Kümmel S, Christgen M, Braun M, Aktas B et al (2022) Endocrine Therapy Response and 21-Gene Expression Assay for Therapy Guidance in HR+/HER2– Early Breast Cancer. J Clin Oncol. 40:2557–2567
doi: 10.1200/JCO.21.02759
pubmed: 35404683
Smith I, Robertson J, Kilburn L, Wilcox M, Evans A, Holcombe C et al (2020) Long-term outcome and prognostic value of Ki67 after perioperative endocrine therapy in postmenopausal women with hormone-sensitive early breast cancer (POETIC): an open-label, multicentre, parallel-group, randomised, phase 3 trial. Lancet Oncol 21(11):1443–1454
doi: 10.1016/S1470-2045(20)30458-7
pubmed: 33152284
pmcid: 7606901
Davey MG, Ryan J, Boland MR, Barry MK, Lowery AJ, Kerin MJ (2021) Clinical utility of the 21-gene assay in predicting response to neoadjuvant endocrine therapy in breast cancer: A systematic review and meta-analysis. Breast 58:113–120
doi: 10.1016/j.breast.2021.04.010
pubmed: 34022714
pmcid: 8142274
Fentiman IS (2018) The endocrinology of male breast cancer. Endocr Relat Cancer 25(6):R365–R373
doi: 10.1530/ERC-18-0117
pubmed: 29752333
Kantor O, King TA (2021) ASO Author Reflections: Tailoring Axillary Surgery After Neoadjuvant Endocrine Therapy for Breast Cancer. Ann Surg Oncol 28(3):1368–1369
doi: 10.1245/s10434-020-09435-0
pubmed: 33389297