Long-term outcome in patients with nodal-positive breast cancer treated with sentinel lymph node biopsy alone after neoadjuvant chemotherapy.

Axillary lymph node dissection Breast Cancer Neoadjuvant chemotherapy Nodal metastasis 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:
05 Oct 2023
Historique:
received: 23 05 2023
accepted: 21 08 2023
medline: 5 10 2023
pubmed: 5 10 2023
entrez: 5 10 2023
Statut: aheadofprint

Résumé

Sentinel lymph node biopsy (SLNB) has yet to be accepted as the standard staging procedure in node positive (cN1) breast cancer patients who had clinical complete response in the axilla (cN0) following neoadjuvant chemotherapy (NAC), due to the presumed high false negative rate associated with SLNB in such scenario. This study aimed to determine whether there is a significant difference in the axillary recurrence rate (ARR) and long-term survival in this group of patients, receiving SLNB alone versus axillary lymph node dissection (ALND). A retrospective cohort of cN1 patients who were rendered cN0 by NAC from January 2014 to December 2018 were identified from the Asan Medical Center database. Patients' characteristics and outcomes were collected and analyzed. 902 cN1 patients treated with NAC and turned cN0 were identified. 477 (52.9%) patients achieved complete pathological response in the axilla (ypN0). At a median follow up of 65 months, ARR was 3.2% in the SLNB only group and 1.8% in the ALND group (p = 0.398). DFS and OS were significantly worse in patients with ALND as compared to patients with SLNB only (p = 0.011 and 0.047, respectively). We noted more patients in the ALND group had T3-4 tumor. In the subgroup analysis, we showed that in the T1-2 subgroup (n = 377), there was no statistically significant difference in DFS and OS (p = 0.242 and 0.671, respectively) between SLNB only and ALND group. Our findings suggest that cN1 patients who were converted to ypN0 following NAC may be safely treated with SLNB only.

Identifiants

DOI: 10.1007/s10549-023-07104-w PMID: 37796365
pubmed: 37796365
doi: 10.1007/s10549-023-07104-w
pii: 10.1007/s10549-023-07104-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

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Auteurs

Sue Zann Lim (SZ)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.
SingHealth Duke-NUS Breast Centre, Singapore, Singapore.

Tae-Kyung Yoo (TK)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.

Sae Byul Lee (SB)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.

Jisun Kim (J)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.

Il Yong Chung (IY)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.

Beom Seok Ko (BS)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.

Jong Won Lee (JW)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.

Byung Ho Son (BH)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.

Sei-Hyun Ahn (SH)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea.

Seonok Kim (S)

Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Hee Jeong Kim (HJ)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 Gill, Songpa-Gu, Seoul, 05505, Republic of Korea. heejeong_kim@amc.seoul.kr.
ORCID: 0000-0002-1343-8138

Classifications MeSH