Sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy

Abstract For residual N1 nodal disease following neoadjuvant chemotherapy (NAC) for patients with breast cancer, the optimal local therapy for axilla is an evolving area. We analyzed the long-term results of these patients according to axillary surgical methods using propensity score matching (PSM)...

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Autores principales:	Jung Whan Chun, Jisun Kim, Il Yong Chung, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Sei-Hyun Ahn, Sae Byul Lee
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2feac9d813874b62915da41dbe72c632
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spelling	oai:doaj.org-article:2feac9d813874b62915da41dbe72c6322021-12-02T16:56:02ZSentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy10.1038/s41598-021-88442-x2045-2322https://doaj.org/article/2feac9d813874b62915da41dbe72c6322021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88442-xhttps://doaj.org/toc/2045-2322Abstract For residual N1 nodal disease following neoadjuvant chemotherapy (NAC) for patients with breast cancer, the optimal local therapy for axilla is an evolving area. We analyzed the long-term results of these patients according to axillary surgical methods using propensity score matching (PSM) to clarify whether omission of axillary lymph node dissection (ALND) is oncologically safe. This was a single institution retrospective study of patients with ypN1 from Asan Medical Center (AMC). We included 324 patients who had undergone axillary surgery with either sentinel lymph node biopsy (SLNB) only or ALND. The patients received NAC at AMC between 2008 and 2013. General indications for ALND included prominent nodes detected clinically before NAC, evident macrometastasis on multiple nodes during SLNB. Patients who had either micrometastasis or macrometastasis in 1 or 2 node(s) were included. SLNB was performed for patients with good responders to NAC with limited nodal burden. Patients were matched for baseline characteristics. After matching, we included 98 patients in each SLNB only group and ALND group respectively. We compared axillary recurrence-free survival (ARFS), distant metastasis-free survival (DMFS), overall survival (OS), and breast cancer-free survival (BCSS) according to the surgical method. The median follow-up period was 71 months. Univariate and multivariate analyses revealed no statistically significant differences between the two groups for ARFS, DMFS, OS, and BCSS. After the propensity score matching, no significant statistical differences were observed in 5-year ARFS, DMFS, OS, and BCSS between the SLNB only group and ALND group. SLNB might be a possible option for ALND in patients with breast cancer who have limited axillary node metastasis after NAC without compromising survival outcomes.Jung Whan ChunJisun KimIl Yong ChungBeom Seok KoHee Jeong KimJong Won LeeByung Ho SonSei-Hyun AhnSae Byul LeeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jung Whan Chun Jisun Kim Il Yong Chung Beom Seok Ko Hee Jeong Kim Jong Won Lee Byung Ho Son Sei-Hyun Ahn Sae Byul Lee Sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy
description	Abstract For residual N1 nodal disease following neoadjuvant chemotherapy (NAC) for patients with breast cancer, the optimal local therapy for axilla is an evolving area. We analyzed the long-term results of these patients according to axillary surgical methods using propensity score matching (PSM) to clarify whether omission of axillary lymph node dissection (ALND) is oncologically safe. This was a single institution retrospective study of patients with ypN1 from Asan Medical Center (AMC). We included 324 patients who had undergone axillary surgery with either sentinel lymph node biopsy (SLNB) only or ALND. The patients received NAC at AMC between 2008 and 2013. General indications for ALND included prominent nodes detected clinically before NAC, evident macrometastasis on multiple nodes during SLNB. Patients who had either micrometastasis or macrometastasis in 1 or 2 node(s) were included. SLNB was performed for patients with good responders to NAC with limited nodal burden. Patients were matched for baseline characteristics. After matching, we included 98 patients in each SLNB only group and ALND group respectively. We compared axillary recurrence-free survival (ARFS), distant metastasis-free survival (DMFS), overall survival (OS), and breast cancer-free survival (BCSS) according to the surgical method. The median follow-up period was 71 months. Univariate and multivariate analyses revealed no statistically significant differences between the two groups for ARFS, DMFS, OS, and BCSS. After the propensity score matching, no significant statistical differences were observed in 5-year ARFS, DMFS, OS, and BCSS between the SLNB only group and ALND group. SLNB might be a possible option for ALND in patients with breast cancer who have limited axillary node metastasis after NAC without compromising survival outcomes.
format	article
author	Jung Whan Chun Jisun Kim Il Yong Chung Beom Seok Ko Hee Jeong Kim Jong Won Lee Byung Ho Son Sei-Hyun Ahn Sae Byul Lee
author_facet	Jung Whan Chun Jisun Kim Il Yong Chung Beom Seok Ko Hee Jeong Kim Jong Won Lee Byung Ho Son Sei-Hyun Ahn Sae Byul Lee
author_sort	Jung Whan Chun
title	Sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy
title_short	Sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy
title_full	Sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy
title_fullStr	Sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy
title_full_unstemmed	Sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy
title_sort	sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2feac9d813874b62915da41dbe72c632
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Sentinel node biopsy alone for breast cancer patients with residual nodal disease after neoadjuvant chemotherapy

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