Axillary Sampling as an Alternative Option for Complete Nodal Response in Triple Negative and HER2 Type Breast Cancer Patients after Neoadjuvant Chemotherapy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: In patients with locally advanced breast cancer, neoadjuvant chemotherapy is widely used. It has a distinct advantage in the downstaging of the primary tumor and provides important information about treatment response. With its increasing usage, concerns over the appropriate management of the axilla have emerged. In this study, we compared oncological outcomes of conventional axillary lymph node dissection (ALND) over axillary sampling (AS) with radiotherapy (RT) in patients who received neoadjuvant chemotherapy. Methods: In this retrospective study, we included female patients with triple negative breast cancer (TNBC) and HER2 type breast cancer who underwent breast and axillary surgery after neoadjuvant chemotherapy between May 2011 to December 2016. A total of 89 patients’ medical records were eligible for analysis. We defined AS as removal of at least four axillary lymph nodes located near the sentinel lymph nodes without full exposure of the axillary vein, long thoracic nerve, and thoracodorsal nerve. Results: The median follow-up period was 47.00 months. The disease-free survival was 69.66 months in the AS with RT group and 69.02 months in the ALND group (p=0.280). The invasive disease-free survival was 75.16 months in the AS with RT group and 78.44 months in the ALND group (p=0.218). Conclusion: AS with radiotherapy might be a feasible surgical option in patients with TNBC and HER2 type breast cancer after neoadjuvant chemotherapy.
Abstract
Purpose: In patients with locally advanced breast cancer, neoadjuvant chemotherapy is widely used. It has a distinct advantage in the downstaging of the primary tumor and provides important information about treatment response. With its increasing usage, concerns over the appropriate management of the axilla have emerged. In this study, we compared oncological outcomes of conventional axillary lymph node dissection (ALND) over axillary sampling (AS) with radiotherapy (RT) in patients who received neoadjuvant chemotherapy. Methods: In this retrospective study, we included female patients with triple negative breast cancer (TNBC) and HER2 type breast cancer who underwent breast and axillary surgery after neoadjuvant chemotherapy between May 2011 to December 2016. A total of 89 patients’ medical records were eligible for analysis. We defined AS as removal of at least four axillary lymph nodes located near the sentinel lymph nodes without full exposure of the axillary vein, long thoracic nerve, and thoracodorsal nerve. Results: The median follow-up period was 47.00 months. The disease-free survival was 69.66 months in the AS with RT group and 69.02 months in the ALND group (p=0.280). The invasive disease-free survival was 75.16 months in the AS with RT group and 78.44 months in the ALND group (p=0.218). Conclusion: AS with radiotherapy might be a feasible surgical option in patients with TNBC and HER2 type breast cancer after neoadjuvant chemotherapy.
참고문헌 (31)
- Mauri D, "Neoadjuvant versus adjuvant systemic treatment in breast cancer : a meta-analysis", J Natl Cancer Inst, 97, pp.188~194 (2005)
- Jones RL, "Neoadjuvant treatment for early-stage breast cancer : opportunities to assess tumour response", Lancet Oncol, 7, pp.869~874 (2006)
- Giuliano AE, "Should ACOSOG Z0011 change practice with respect to axillary lymph node dissection for a positive sentinel lymph node biopsy in breast cancer", Clin Exp Metastasis, 29, pp.687~692 (2012)
- Vila J, "Nomograms for predicting axillary response to neoadjuvant chemotherapy in clinically node-positive patients with breast cancer", Ann Surg Oncol, 23, pp.3501~3509 (2016)
- Bilimoria KY, "Comparison of sentinel lymph node biopsy alone and completion axillary lymph node dissection for node-positive breast cancer", J Clin Oncol, 27, pp.2946~2953 (2009)
- Mamounas EP, "Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer : results from national surgical adjuvant breast and bowel project protocol B-27", J Clin Oncol, 23, pp.2694~2702 (2005)
- Boughey JC, "Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer", JAMA, 310 (2013)
- Kuehn T, "Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy(SENTINA) : a prospective, multicentre cohort study", Lancet Oncol, 14, pp.609~618 (2013)
- Newman EA, "Sentinel lymph node biopsy performed after neoadjuvant chemotherapy is accurate in patients with documented node-positive breast cancer at presentation", Ann Surg Oncol, 14, pp.2946~ (2007)
- Classe JM, "Sentinel lymph node biopsy after neoadjuvant chemotherapy for advanced breast cancer : results of ganglion sentinelle et chimiothérapie neoadjuvante, a French prospective multicentric study", J Clin Oncol, 27, pp.726~732 (2009)
- Alvarado R, "The role for sentinel lymph node dissection after neoadjuvant chemotherapy in patients who present with node-positive breast cancer", Ann Surg Oncol, 19, pp.3177~3184 (2012)
- Boughey JC, "Axillary ultrasound after neoadjuvant chemotherapy and its impact on sentinel lymph node surgery : results from the American college of surgeons oncology group Z1071 trial(alliance)", J Clin Oncol, 33, pp.3386~3393 (2015)
- Boughey JC, "Identification and resection of clipped node decreases the false-negative rate of sentinel lymph node surgery in patients presenting with node-positive breast cancer(T0-T4, N1-N2)who receive neoadjuvant chemotherapy : results from ACOSOG Z1071(alliance)", Ann Surg, 263, pp.802~807 (2016)
- Boileau JF, "Sentinel node biopsy after neoadjuvant chemotherapy in biopsy-proven node-positive breast cancer : the SN FNAC study", J Clin Oncol, 33, pp.258~264 (2015)
- Ryu JM, "Predictive factors for nonsentinel lymph node metastasis in patients with positive sentinel lymph nodes after neoadjuvant chemotherapy: nomogram for predicting nonsentinel lymph node metastasis", Clin Breast Cancer, 17, pp.550~558 (2017)
- Barnwell JM, "Sentinel node biopsy in breast cancer", Ann Surg Oncol, 5, pp.126~130 (1998)
- Brenin DR, "Management of axillary lymph nodes in breast cancer : a national patterns of care study of 17, 151 patients", Ann Surg, 230, pp.686~ (1999)
- Giuliano AE, "Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis : a randomized clinical trial", JAMA, 305, pp.569~575 (2011)
- Salmon RJ, "Sentinel node biopsy or limited oriented axillary dissection(LOAD)in early breast cancer", Eur J Surg Oncol, 31, pp.949~953 (2005)
- Lumachi F, "Axillary node sampling in conjunction with sentinel node biopsy in patients with breast cancer. A prospective preliminary study", Anticancer Res, 31, pp.693~697 (2011)
- Bassi KK, "Role of axillary sampling in the era of sentinel lymph node biopsy : a critical review", Indian J Cancer, 49, pp.66~73 (2012)
- Li J, "Partial axillary lymph node dissection inferior to the intercostobrachial nerves complements sentinel node biopsy in patients with clinically node-negative breast cancer", BMC Surg, 15, pp.79~ (2015)
- Donker M, "Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer(EORTC 10981-22023 AMAROS) : a randomised, multicentre, open-label, phase 3 non-inferiority trial", Lancet Oncol, 15, pp.1303~1310 (2014)
- Boughey JC, "Tumor biology correlates with rates of breastconserving surgery and pathologic complete response after neoadjuvant chemotherapy for breast cancer : findings from the ACOSOG Z1071(alliance)prospective multicenter clinical trial", Ann Surg, 260, pp.608~614 (2014)
- Kim JY, "Prognostic nomogram for prediction of axillary pathologic complete response after neoadjuvant chemotherapy in cytologically proven node-positive breast cancer", Medicine, 94, pp.e1720~ (2015)
- Diego EJ, "Axillary staging after neoadjuvant chemotherapy for breast cancer : a pilot study combining sentinel lymph node biopsy with radioactive seed localization of pre-treatment positive axillary lymph nodes", Ann Surg Oncol, 23, pp.1549~1553 (2016)
- Lee J, "5-year oncological outcomes of targeted axillary sampling in pT1-2N1breast cancer", Asian J Surg, 42, pp.681~687 (2019)
- Morrow M, "To cut is to cure : can we really apply Z11in practice", Ann Surg Oncol, 18, pp.2413~2415 (2011)
- Galimberti V, "Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases(IBCSG 23-01) : a phase 3 randomised controlled trial", Lancet Oncol, 14, pp.297~305 (2013)
- Offersen BV, "ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer", Radiother Oncol, 114, pp.3~10 (2015)
- Jeruss JS, "Factors predicting additional disease in the axilla in patients with positive sentinel lymph nodes after neoadjuvant chemotherapy", Cancer, 112, pp.2646~2654 (2008)