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?

被引:5
作者
Guo, Xuhui [1 ,2 ]
Zhang, Jiao [1 ,2 ]
Gong, Xilong [1 ,2 ]
Wang, Jia [1 ,2 ]
Dai, Hao [1 ,2 ]
Jiao, Dechuang [1 ,2 ]
Ling, Rui [3 ]
Zhao, Yi [4 ]
Yang, Hongjian [5 ]
Liu, Yunjiang [6 ]
Liu, Ke [7 ]
Zhang, Jianguo [8 ]
Mao, Dahua [9 ]
He, Jianjun [10 ]
Yu, Zhigang [11 ]
Liu, Yinhua [12 ]
Fu, Peifen [13 ]
Wang, Jiandong [14 ]
Jiang, Hongchuan [15 ]
Zhao, Zuowei [16 ]
Tian, Xingsong [17 ]
Cao, Zhongwei [18 ]
Wu, Kejin [19 ]
Song, Ailin [20 ]
Jin, Feng [21 ]
Fan, Zhimin [22 ]
Liu, Zhenzhen [1 ,2 ]
机构
[1] Zhengzhou Univ, Henan Breast Canc Ctr, Dept Breast Dis, Affiliated Canc Hosp, Dongming Rd, Zhengzhou 450008, Henan, Peoples R China
[2] Henan Canc Hosp, Dongming Rd, Zhengzhou 450008, Henan, Peoples R China
[3] Fourth Mil Med Univ, Xijing Hosp, Dept Thyroid Breast & Vasc Surg, Xian 710032, Shaanxi, Peoples R China
[4] China Med Univ, Shengjing Hosp, Surg Oncol Dept, Shenyang 110022, Liaoning, Peoples R China
[5] Chinese Acad Sci, Zhejiang Canc Hosp, Inst Basic Med & Canc IBMC, Dept Breast Surg,Canc Hosp,Univ Chinese Acad Sci, Hangzhou 310022, Zhejiang, Peoples R China
[6] Hebei Med Univ, Hosp 4, Dept Surg, Shijiazhuang 052360, Hebei, Peoples R China
[7] Jilin Canc Hosp, Dept Breast Surg 4, Changchun 130012, Jilin, Peoples R China
[8] Harbin Med Univ, Affiliated Hosp 2, Dept Breast Surg, Harbin 150086, Heilongjiang, Peoples R China
[9] Guizhou Med Univ, Affiliated Wudang Hosp, Dept Breast Surg, Guiyang 550009, Guizhou, Peoples R China
[10] Xi An Jiao Tong Univ, Affiliated Hosp 1, Dept Breast Surg, Xian 710061, Shaanxi, Peoples R China
[11] Shandong Univ, Hosp 2, Cheeloo Coll Med, Dept Breast Surg, Jinan 250033, Shandong, Peoples R China
[12] Peking Univ First Hosp, Breast Dis Ctr, Beijing 100034, Peoples R China
[13] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Breast Surg, Hangzhou 310003, Zhejiang, Peoples R China
[14] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Gen Surg, Beijing 100852, Peoples R China
[15] Capital Med Univ, Beijing Chaoyang Hosp, Dept Breast Surg, Beijing 100020, Peoples R China
[16] Dalian Med Univ, Affiliated Hosp 2, Dept Breast Surg, Dalian 116023, Liaoning, Peoples R China
[17] Shandong Univ, Shandong Prov Hosp, Dept Breast & Thyroid Surg, Jinan 250021, Shandong, Peoples R China
[18] Inner Mongolia Autonomous Reg Peoples Hosp, Dept Thyroid Breast Hernia & Vasc Surg, Hohhot 010017, Inner Mongolia, Peoples R China
[19] Fudan Univ, Dept Breast Surg, Obstet & Gynecol Hosp, Shanghai 200433, Peoples R China
[20] Lanzhou Univ, Hosp 2, Dept Gen Surg, Lanzhou 730000, Gansu, Peoples R China
[21] China Med Univ, Hosp 1, Dept Breast Surg, Shenyang 110002, Liaoning, Peoples R China
[22] First Hosp Jilin Univ, Dept Breast Surg, Changchun 130021, Jilin, Peoples R China
基金
英国科研创新办公室;
关键词
CHEMOTHERAPY; MULTICENTER; SURGERY; BIOPSY;
D O I
10.1016/j.breast.2024.103671
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
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页数:6
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