| Institution: | 1. Breast Unit, Cancer Center, IRCCS Clinical Institute Humanitas, Rozzano (MI), Italy;2. Anatomia Patologica Ospedaliera, IRCCS Ospedale Policlinico San Martino, Genova, Italy;3. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genova, Italy;4. Breast Unit, Ospedale Villa Scassi, Genova, Italy;1. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia;2. Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia;3. Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia;4. Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District and Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia;5. Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia;1. Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria;2. Department of Orthopaedic Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands;3. Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, Fulham Road, SW3 6JJ, London, United Kingdom;4. Institute of Pathology, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria;5. Sarcoma Centre, HELIOS-Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany;6. Department of Orthopaedics and Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria;7. Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria;1. Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel;2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;1. Croydon University Hospital, Croydon, UK;2. Royal Marsden NHS Foundation Trust, Sutton, UK;3. Imperial College, London, UK;4. Pelican Cancer Foundation, Basingstoke, UK;5. Basingstoke Hospital, Hampshire Hospitals Foundation Trust, Basingstoke, UK |
| Abstract: | BackgroundWhether the extent of residual disease in the sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC) influences the prognosis in clinically node-positive breast cancer (BC) patients remains to be ascertained.MethodsOne hundred and thirty-four consecutive cN+/BC-patients received NAC followed by SLN biopsy and axillary lymph node dissection. Cumulative incidence of overall (OS) and disease-free (DFS) survival, BC-related recurrences and death from BC were assessed using the Kaplan-Meier method both in the whole patient population and according to the SLN status. The log rank test was used for comparisons between groups.ResultsThe SLN was identified in 123/134 (91.8%) patients and was positive in 98/123 (79.7%) patients. Sixty-five of them (66.3%) had other axillary nodes involved. SLN sensitivity and false-negative rate were 88.0% and 2.0%, Median follow-up was 10.2 years. Ten-year cumulative incidence of axillary, breast and distant recurrences, and death from BC were 6.5%, 11.9%, 33.4% and 31.3%, respectively. Ten-year OS and DFS were 67.3% and 55.9%. When stratified by SLN status, 10-year cumulative incidence of BC-related and loco-regional events, and death from BC were similar between disease-free SLN and micrometastatic SLN subgroups (28.9% vs 30.2%, p = 0.954; 21.6% vs 13.4%, p = 0.840; 12.9 vs 24.5%, p=0.494). Likewise, 10-year OS and DFS were comparable (80.0% vs 75.5%, p=0.975 and 68.0% vs 69.8, p=0.836). Both OS and DFS were lower in patients presenting a macrometastatic SLN (60.2% and 47.5%).ConclusionOutcome of patients with micrometastatic SLN was similar to that of patients with disease-free SLN, which was more favorable as compared to that of patients with macrometastatic SLN. |
