Correlation between outcome and extent of residual disease in the sentinel node after neoadjuvant chemotherapy in clinically fine-needle proven node-positive breast cancer patients

Autor: Angelica Della Valle, Corrado Tinterri, Erika Barbieri, Elsa Garrone, Paolo Bruzzi, Stefano Spinaci, Emilia Marrazzo, Franca Carli, Giuseppe Canavese, Beatrice Dozin
Rok vydání: 2021
Předmět:
Adult
medicine.medical_specialty
Neoplasm
Residual
medicine.medical_treatment
Sentinel lymph node
Biopsy
Fine-Needle
Breast Neoplasms
Gastroenterology
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Breast cancer
Internal medicine
Biopsy
Medicine
Humans
Cumulative incidence
030212 general & internal medicine
False Negative Reactions
Aged
Aged
80 and over
Chemotherapy
medicine.diagnostic_test
business.industry
Sentinel Lymph Node Biopsy
Incidence
Carcinoma
Ductal
Breast
Axillary Lymph Node Dissection
General Medicine
Sentinel node
Middle Aged
medicine.disease
Neoadjuvant Therapy
Log-rank test
Survival Rate
Carcinoma
Lobular
Oncology
Neoplasm Micrometastasis
030220 oncology & carcinogenesis
Axilla
Lymph Node Excision
Surgery
Female
Lymph Nodes
Neoplasm Recurrence
Local
Sentinel Lymph Node
business
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 47(8)
ISSN: 1532-2157
Popis: Background Whether the extent of residual disease in the sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC) influences the prognosis in clinically node-positive breast cancer (BC) patients remains to be ascertained. Methods One hundred and thirty-four consecutive cN+/BC-patients received NAC followed by SLN biopsy and axillary lymph node dissection. Cumulative incidence of overall (OS) and disease-free (DFS) survival, BC-related recurrences and death from BC were assessed using the Kaplan-Meier method both in the whole patient population and according to the SLN status. The log rank test was used for comparisons between groups. Results The SLN was identified in 123/134 (91.8%) patients and was positive in 98/123 (79.7%) patients. Sixty-five of them (66.3%) had other axillary nodes involved. SLN sensitivity and false-negative rate were 88.0% and 2.0%, Median follow-up was 10.2 years. Ten-year cumulative incidence of axillary, breast and distant recurrences, and death from BC were 6.5%, 11.9%, 33.4% and 31.3%, respectively. Ten-year OS and DFS were 67.3% and 55.9%. When stratified by SLN status, 10-year cumulative incidence of BC-related and loco-regional events, and death from BC were similar between disease-free SLN and micrometastatic SLN subgroups (28.9% vs 30.2%, p = 0.954; 21.6% vs 13.4%, p = 0.840; 12.9 vs 24.5%, p=0.494). Likewise, 10-year OS and DFS were comparable (80.0% vs 75.5%, p=0.975 and 68.0% vs 69.8, p=0.836). Both OS and DFS were lower in patients presenting a macrometastatic SLN (60.2% and 47.5%). Conclusion Outcome of patients with micrometastatic SLN was similar to that of patients with disease-free SLN, which was more favorable as compared to that of patients with macrometastatic SLN.
Databáze: OpenAIRE
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