Evaluation of traditional targeted axillary dissection eligibility criteria for node-positive breast cancer after neoadjuvant chemotherapy in a prospective multicenter registry
© 2024 Published by Elsevier Ltd..
INTRODUCTION: Targeted axillary dissection (TAD) is performed after neoadjuvant systemic therapy (NST) to decrease the rate of non-therapeutic axillary dissection (ALND) for patients with node-positive breast cancer. In order to ensure the oncologic safety of TAD, eligibility criteria resulting in a low false negative rate (FNR) have been proposed. The purpose of this study was to evaluate the utility of the traditional criteria.
METHODS: Data was collected from a prospective multicenter registry. In order to ascertain FNRs, pathologic findings in the sentinel lymph nodes (LN)s, malignant clipped LN, and axillary contents were determined. The FNRs within TAD eligibility criterion groups were compared.
RESULTS: A total of 110 patients underwent TAD and ALND, and were therefore eligible for analysis. TAD retained a low FNR in advanced clinical T-N stage compared with earlier disease (T stage: 95% CI 0.00-11.93, p = 0.42; N stage: 95% CI 0.00-8.76, p = 0.31). Presentation with ≥4 abnormal LNs on axillary ultrasound did not predict a high TAD FNR (95% CI 0.00-5.37, p = 0.16). No significant differences were noted in TAD FNR when single was compared with dual tracer (blue dye vs dual tracer 95% CI 0.72-52.49, p = 0.13; radiotracer vs dual tracer 0.04-20.11, p = 0.51). Excision of the clipped LN and only one SLN was as accurate as excision of the clipped LN and ≥2 SLNs (95% CI 0.00-10.61, p = 0.38).
CONCLUSIONS: TAD retained a low FNR among patients traditionally considered ineligible for this technique. However, excision of the clipped LN and at least one SLN remained essential to a low FNR.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology - 50(2024), 4 vom: 29. Apr., Seite 108245 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Loveland-Jones, Catherine [VerfasserIn] |
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| Links: |
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| Themen: |
Breast cancer |
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| Anmerkungen: |
Date Completed 01.04.2024 Date Revised 01.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ejso.2024.108245 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369741846 |
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| 100 | 1 | |a Loveland-Jones, Catherine |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Evaluation of traditional targeted axillary dissection eligibility criteria for node-positive breast cancer after neoadjuvant chemotherapy in a prospective multicenter registry |
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| 500 | |a Date Revised 01.04.2024 | ||
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| 520 | |a © 2024 Published by Elsevier Ltd. | ||
| 520 | |a INTRODUCTION: Targeted axillary dissection (TAD) is performed after neoadjuvant systemic therapy (NST) to decrease the rate of non-therapeutic axillary dissection (ALND) for patients with node-positive breast cancer. In order to ensure the oncologic safety of TAD, eligibility criteria resulting in a low false negative rate (FNR) have been proposed. The purpose of this study was to evaluate the utility of the traditional criteria | ||
| 520 | |a METHODS: Data was collected from a prospective multicenter registry. In order to ascertain FNRs, pathologic findings in the sentinel lymph nodes (LN)s, malignant clipped LN, and axillary contents were determined. The FNRs within TAD eligibility criterion groups were compared | ||
| 520 | |a RESULTS: A total of 110 patients underwent TAD and ALND, and were therefore eligible for analysis. TAD retained a low FNR in advanced clinical T-N stage compared with earlier disease (T stage: 95% CI 0.00-11.93, p = 0.42; N stage: 95% CI 0.00-8.76, p = 0.31). Presentation with ≥4 abnormal LNs on axillary ultrasound did not predict a high TAD FNR (95% CI 0.00-5.37, p = 0.16). No significant differences were noted in TAD FNR when single was compared with dual tracer (blue dye vs dual tracer 95% CI 0.72-52.49, p = 0.13; radiotracer vs dual tracer 0.04-20.11, p = 0.51). Excision of the clipped LN and only one SLN was as accurate as excision of the clipped LN and ≥2 SLNs (95% CI 0.00-10.61, p = 0.38) | ||
| 520 | |a CONCLUSIONS: TAD retained a low FNR among patients traditionally considered ineligible for this technique. However, excision of the clipped LN and at least one SLN remained essential to a low FNR | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Breast cancer | |
| 650 | 4 | |a Neoadjuvant chemotherapy | |
| 650 | 4 | |a Registry | |
| 650 | 4 | |a Targeted axillary dissection | |
| 700 | 1 | |a Gaughan, John |e verfasserin |4 aut | |
| 700 | 1 | |a Caudle, Abigail |e verfasserin |4 aut | |
| 700 | 1 | |a Murphy, Brittany |e verfasserin |4 aut | |
| 700 | 1 | |a Samiian, Laila |e verfasserin |4 aut | |
| 700 | 1 | |a Byrum, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Brill, Kristen |e verfasserin |4 aut | |
| 700 | 1 | |a Germaine, Pauline |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xinmin |e verfasserin |4 aut | |
| 700 | 1 | |a Yoon-Flannery, Kay |e verfasserin |4 aut | |
| 700 | 1 | |a Carter, Teralyn |e verfasserin |4 aut | |
| 700 | 1 | |a Lopez, Adrian |e verfasserin |4 aut | |
| 700 | 1 | |a Gruner, Ryan |e verfasserin |4 aut | |
| 700 | 1 | |a Fantazzio, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Kuerer, Henry |e verfasserin |4 aut | |
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