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?
Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved..
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+）breast cancer patients following neoadjuvant therapy（NAT）.
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
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| Enthalten in: |
Breast (Edinburgh, Scotland) - 73(2024) vom: 01. Feb., Seite 103671 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Guo, Xuhui [VerfasserIn] |
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| Anmerkungen: |
Date Completed 27.02.2024 Date Revised 27.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.breast.2024.103671 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367681250 |
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| 100 | 1 | |a Guo, Xuhui |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Axillary lymph node dissection in triple-negative or HER2-positive breast cancer patients with clinical N2 achieving pathological complete response after neoadjuvant therapy |b Is it necessary? |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 27.02.2024 | ||
| 500 | |a Date Revised 27.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a 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+）breast cancer patients following neoadjuvant therapy（NAT） | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Zhang, Jiao |e verfasserin |4 aut | |
| 700 | 1 | |a Gong, Xilong |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jia |e verfasserin |4 aut | |
| 700 | 1 | |a Dai, Hao |e verfasserin |4 aut | |
| 700 | 1 | |a Jiao, Dechuang |e verfasserin |4 aut | |
| 700 | 1 | |a Ling, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Hongjian |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Yunjiang |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Ke |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Jianguo |e verfasserin |4 aut | |
| 700 | 1 | |a Mao, Dahua |e verfasserin |4 aut | |
| 700 | 1 | |a He, Jianjun |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Zhigang |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Yinhua |e verfasserin |4 aut | |
| 700 | 1 | |a Fu, Peifen |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jiandong |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Hongchuan |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Zuowei |e verfasserin |4 aut | |
| 700 | 1 | |a Tian, Xingsong |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Zhongwei |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Kejin |e verfasserin |4 aut | |
| 700 | 1 | |a Song, Ailin |e verfasserin |4 aut | |
| 700 | 1 | |a Jin, Feng |e verfasserin |4 aut | |
| 700 | 1 | |a Fan, Zhimin |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Zhenzhen |e verfasserin |4 aut | |
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