Sentinel Node Biopsy after Neoadjuvant Chemotherapy for Breast Cancer: Preliminary Experience with Clinically Node Negative Patients after Systemic Treatment
Autor: | Sabatino D'Archi, Alejandro Martin Sanchez, Riccardo Masetti, Fabio Marazzi, Flavia De Lauretis, Lorenzo Scardina, Stefano Magno, Alba Di Leone, Gianluca Franceschini, Annamaria Martullo, Armando Orlandi, F. Moschella, Maria Natale, Daniela Terribile, Elena Jane Mason, A Franco |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Settore MED/18 - CHIRURGIA GENERALE Sentinel lymph node Medicine (miscellaneous) lcsh:Medicine 030230 surgery Article 03 medical and health sciences 0302 clinical medicine Breast cancer sentinel lymph node breast cancer locally advanced breast cancer Biopsy medicine Clinical significance Chemotherapy medicine.diagnostic_test business.industry lcsh:R Axillary Lymph Node Dissection systemic treatment Sentinel node medicine.disease 030220 oncology & carcinogenesis Lymph Radiology mini-invasive treatment business neoadjuvant chemotherapy |
Zdroj: | Journal of Personalized Medicine Volume 11 Issue 3 Journal of Personalized Medicine, Vol 11, Iss 172, p 172 (2021) |
ISSN: | 2075-4426 |
DOI: | 10.3390/jpm11030172 |
Popis: | Sentinel lymph node biopsy (SLNB) following neoadjuvant treatment (NACT) has been questioned by many studies that reported heterogeneous identification (IR) and false negative rates (FNR). As a result, some patients receive axillary lymph node dissection (ALND) regardless of response to NACT, leading to a potential overtreatment. To better assess reliability and clinical significance of SLNB status on ycN0 patients, we retrospectively analyzed oncological outcomes of 399 patients treated between January 2016 and December 2019 that were either cN0-ycN0 (219 patients) or cN1/2-ycN0 (180 patients). The Endpoints of our study were to assess, furthermore than IR: oncological outcomes as Overall Survival (OS) Distant Disease Free Survival (DDFS) and Regional Disease Free Survival (RDFS) according to SLNB status. SLN identification rate was 96.8% (98.2% in patients cN0-ycN0 and 95.2% in patients cN+-ycN0). A median number of three lymph nodes were identified and removed. Among cN0-ycN0 patients, 149 (68%) were confirmed ypN0(sn), whereas regarding cN1/2-ycN0 cases 86 (47.8%) confirmed an effective downstaging to ypN0. Three year OS, DDFS and RDFS were significantly related to SLNB positivity. Our data seemed to confirm SLNB feasibility following NACT in ycN0 patients, furthermore reinforcing its predictive role in a short observation timing. |
Databáze: | OpenAIRE |
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