Axillary lymph node dissection in triple-negative or HER2-positive breast cancer patients with clinical N2 achieving pathological complete response after neoadjuvant therapy: Is it necessary?
Breast
; 73: 103671, 2024 Feb.
Article
in En
| MEDLINE
| ID: mdl-38277714
ABSTRACT
AIM:
This study aims to identify suitable candidates for axillary sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) among clinical N2 (cN2) triple-negative (TN) or HER2 positive (HER2+ï¼breast cancer patients following neoadjuvant therapyï¼NATï¼.BACKGROUND:
Despite the substantial axillary burden in cN2 breast cancer patients, high pathological response rates can be achieved with NAT in TN or HER2+ subtypes, thus enabling potential downstaging of axillary surgery.METHODS:
A retrospective analysis was conducted on data from the CSBrS-012 study, screening 709 patients with initial cN2, either HER2+ or TN subtype, from January 1, 2010 to December 31, 2020. The correlation between axillary pathologic complete response (pCR) (yPN0) and breast pCR was examined.RESULTS:
Among the 177 cN2 patients who achieved breast pCR through NAT, 138 (78.0 %) also achieved axillary pCR. However, in the 532 initial clinical N2 patients who did not achieve breast pCR, residual axillary lymph node metastasis persisted in 77.4 % (412/532) of cases. The relative risk of residual axillary lymph node metastasis in patients who did not achieve breast pCR was 12.4 (8.1-19.1), compared to those who did achieve breast pCR, P < 0.001.CONCLUSION:
For cN2 TN or HER2+ breast cancer patients who achieve breast pCR following NAT, consideration could be given to downstaging and performing an axillary SLNB or TAD.
Full text:
1
Database:
MEDLINE
Main subject:
Breast Neoplasms
Type of study:
Etiology_studies
Limits:
Female
/
Humans
Language:
En
Journal:
Breast
Journal subject:
ENDOCRINOLOGIA
/
NEOPLASIAS
Year:
2024
Type:
Article
Affiliation country:
China