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：6

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

来源：

BREAST | 2024年 / 73卷

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.

引用

页数：6

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