| Autor: |
Vanni G; Breast Unit, Department of Surgical Science, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy., Materazzo M; Breast Unit, Department of Surgical Science, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy.; Ph.D. Program in Applied Medical-Surgical Sciences, Department of Surgical Science, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy., Paduano F; Breast Unit, Department of Surgical Science, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy., Pellicciaro M; Breast Unit, Department of Surgical Science, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy.; Ph.D. Program in Applied Medical-Surgical Sciences, Department of Surgical Science, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy., Di Mauro G; Department of Human Pathology 'G. Barresi', University of Messina, 98125 Messina, Italy., Toscano E; Department of Human Pathology 'G. Barresi', University of Messina, 98125 Messina, Italy., Tacconi F; Department of Surgical Sciences, Unit of Thoracic Surgery, Tor Vergata University, 00133 Rome, Italy., Longo B; Breast Unit, Department of Surgical Science, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy.; Plastic and Reconstructive Surgery at Department of Surgical Science, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy., Cervelli V; Plastic and Reconstructive Surgery at Department of Surgical Science, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy., Berretta M; Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy., Buonomo OC; Breast Unit, Department of Surgical Science, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy.; General Surgery Program, Department of Health Science, UNIBAS, University of Basilicata, Via dell'Ateneo Lucano, 10, 85100 Potenza, Italy. |
| Abstrakt: |
Background : The SOUND study demonstrated that an axillary de-escalation may be sufficient in locoregional and distant disease control in selected early breast cancer (EBC) patients. To establish any preoperative variables that may drive sentinel lymph node biopsy (SLNB) omission, a study named sentinel omission risk factor (SOFT) 1.23 was planned. Methods: A single-center retrospective study from a prospectively maintained database was designed, aiming at underlying preoperative prognostic factors involved in sentinel lymph node (SLN) metastasis (lymph node involvement (LN+) vs. negative lymph node (LN-) group). Secondary outcomes included surgical room occupancy analysis for SLNB in patients fulfilling the SOUND study inclusion criteria. The institutional ethical committee Area Territoriale Lazio 2 approved the study (n° 122/23). Results: Between 1 January 2022 and 30 June 2023, 160 patients were included in the study and 26 (%) were included in the LN+ group. Multifocality, higher cT stage, and larger tumor diameter were reported in the LN+ group ( p = 0.020, p = 0.014, and 0.016, respectively). Tumor biology, including estrogen and progesterone receptors, and molecular subtypes showed association with the LN+ group ( p < 0.001; p = 0.001; and p = 0.001, respectively). A total of 117 (73.6%) patients were eligible for the SOUND study and the potential operating room time saved was 2696.81 min. Conclusions: De-escalating strategies may rationalize healthcare activities. Multifactorial risk stratification may further refine the selection of patients who could benefit from SLNB omission. |
