Positive sentinel node in luminal A-like breast cancer patients - implications for adjuvant chemotherapy?
Autor: | Axel Stenmark Tullberg, Dan Lundstedt, Roger Olofsson Bagge, Per Karlsson |
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Rok vydání: | 2018 |
Předmět: |
Oncology
Adult medicine.medical_specialty medicine.medical_treatment Sentinel lymph node Breast Neoplasms 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Radiology Nuclear Medicine and imaging Registries Lymph node Aged Retrospective Studies Sweden Chemotherapy business.industry Sentinel Lymph Node Biopsy Axillary Lymph Node Dissection Retrospective cohort study Hematology General Medicine Sentinel node Middle Aged medicine.disease Axilla medicine.anatomical_structure Chemotherapy Adjuvant 030220 oncology & carcinogenesis Lymphatic Metastasis Lymph Node Excision Female Neoplasm Recurrence Local Sentinel Lymph Node business |
Zdroj: | Acta oncologica (Stockholm, Sweden). 58(2) |
ISSN: | 1651-226X |
Popis: | Background In luminal A-like breast cancer, the indication for adjuvant chemotherapy still is largely based on lymph nodestatus. Sentinel node (SN) positive patients who are no longer recommended an axillary lymph node dissection (ALND) risk undertreatment, especially if they have ≥4 lymph node metastases (LNMs). Aim To quantify the group of SN positive luminal A-like patients with ≥4 LNMs and to investigate if the ratio between positive SNs and examined SNs (SN ratio) can provide information of the axillary tumor burden. Material and methods Nearly 370 patients between 2014-2016 in Western Sweden with a clinically node-negative invasive breast cancer treated with both SNB and subsequent ALND were included. SNB findings were compared to ALND findings and the ability of the SN ratio to describe the axillary tumor burden was evaluated using multivariable analysis. Results In total,17.6% of patients with luminal A-like tumors had ≥4 LNMs. The SN ratio was statistically significant for predicting ≥4 LNMs among luminal A-like patients (p = .013, OR 1.89 (95% CI 1.14-3.12) per 0.1 increment in SN ratio). Conclusions One sixth of patients with SN positive luminal A-like tumors risk undertreatment. The SN ratio may aid in identifying many of these patients. |
Databáze: | OpenAIRE |
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