Sentinel Node Biopsy after Neoadjuvant Chemotherapy for Breast Cancer: Preliminary Experience with Clinically Node Negative Patients after Systemic Treatment

Journal of Personalized Medicine

Fabio Marazzi¹  Armando Orlandi²  FlaviaDe Lauretis²  Gianluca Franceschini²  AlejandroMartin Sanchez²  AlbaDi Leone²  ElenaJ. Mason²  Annamaria Martullo²  Antonio Franco²  Riccardo Masetti²  Lorenzo Scardina²  Stefano Magno²  Francesca Moschella²  Daniela Terribile²  Sabatino D’Archi²  Maria Natale² 

[1] Division of Radiotherapy, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;Multidisciplinary Breast Center, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy;

关键词: neoadjuvant chemotherapy;    sentinel lymph node;    breast cancer;    systemic treatment;    locally advanced breast cancer;    mini-invasive treatment;   

DOI  :  10.3390/jpm11030172

来源: DOAJ

【 摘 要 】

Sentinel lymph node biopsy (SLNB) following neoadjuvant treatment (NACT) has been questioned by many studies that reported heterogeneous identification (IR) and false negative rates (FNR). As a result, some patients receive axillary lymph node dissection (ALND) regardless of response to NACT, leading to a potential overtreatment. To better assess reliability and clinical significance of SLNB status on ycN0 patients, we retrospectively analyzed oncological outcomes of 399 patients treated between January 2016 and December 2019 that were either cN0-ycN0 (219 patients) or cN1/2-ycN0 (180 patients). The Endpoints of our study were to assess, furthermore than IR: oncological outcomes as Overall Survival (OS); Distant Disease Free Survival (DDFS); and Regional Disease Free Survival (RDFS) according to SLNB status. SLN identification rate was 96.8% (98.2% in patients cN0-ycN0 and 95.2% in patients cN+-ycN0). A median number of three lymph nodes were identified and removed. Among cN0-ycN0 patients, 149 (68%) were confirmed ypN0(sn), whereas regarding cN1/2-ycN0 cases 86 (47.8%) confirmed an effective downstaging to ypN0. Three year OS, DDFS and RDFS were significantly related to SLNB positivity. Our data seemed to confirm SLNB feasibility following NACT in ycN0 patients, furthermore reinforcing its predictive role in a short observation timing.

【 授权许可】

Unknown