Gilles Houvenaeghel1, Jean Marc Classe2, Jean-Rémy Garbay3, Sylvie Giard4, Monique Cohen5, Chistine Faure6, Hélène Charytansky7, Roman Rouzier8, Emile Daraï9, Delphine Hudry10, Pierre Azuar11, Richard Villet12, Pierre Gimbergues13, Christine Tunon de Lara14, Marc Martino15, Jean Fraisse10, François Dravet2, Marie Pierre Chauvet4, Anthony Goncalves16, Eric Lambaudie16. 1. Institut Paoli Calmettes and CRCM, 232 Bd Ste Marguerite, 13009 Marseille, France; Institut Paoli Calmettes, Biostatistic Department, 232 Bd Ste Marguerite, 13009 Marseille, France; Aix Marseille Université, 25 Bd Jean Moulin, 13005 Marseille, France. Electronic address: g.houvenaeghel@orange.fr. 2. Institut René Gauducheau, Site hospitalier Nord, Boulevard Professeur Jacques Monod, 44805 St Herblain, France. 3. Institut Gustave Roussy, 114 rue Edouard Vaillant, 94800 Villejuif, France. 4. Centre Oscar Lambret, 3 rue Frédéric Combenal, 59000 Lille, France. 5. Institut Paoli Calmettes and CRCM, 232 Bd Ste Marguerite, 13009 Marseille, France; Institut Paoli Calmettes, Biostatistic Department, 232 Bd Ste Marguerite, 13009 Marseille, France. 6. Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, France. 7. Centre Claudius Regaud, 20-24 rue du Pont St Pierre, 31059 Toulouse, France. 8. Centre René Huguenin, 35 rue Dailly, 92210 Saint Cloud, France. 9. Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France. 10. Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000 Dijon, France. 11. Hôpital de Grasse, Chemin de Clavary, 06130 Grasse, France. 12. Hôpital des Diaconnesses, 18 rue du Sergent Bauchat, 75012 Paris, France. 13. Centre Jean Perrin, 58 rue Montalembert, 63000 Clermont Ferrand, France. 14. Institut Bergonié, 229 Cours de l'Argonne, 33000 Bordeaux, France. 15. Institut Paoli Calmettes and CRCM, 232 Bd Ste Marguerite, 13009 Marseille, France. 16. Institut Paoli Calmettes and CRCM, 232 Bd Ste Marguerite, 13009 Marseille, France; Institut Paoli Calmettes, Biostatistic Department, 232 Bd Ste Marguerite, 13009 Marseille, France; Aix Marseille Université, 25 Bd Jean Moulin, 13005 Marseille, France.
Abstract
BACKGROUND: The rate of axillary recurrence (AR) after sentinel lymph node biopsy is usually low but few studies investigated its impact on survival. Our aim was to determine the rate and predictive factors of AR in a large cohort of breast cancer patients and its impact on survival. PATIENTS AND METHODS: From 1999 to 2013, 14,095 patients who underwent surgery for clinically N0 previously untreated breast cancer and had sentinel lymph node biopsy were analysed. A simplified score predictive of AR was established. RESULTS: Median follow-up was 55.2 months. AR was observed in 0.51% of cases, with a median time to onset of 43.4 months. In multivariate analysis, the occurrence of AR was significantly correlated with grade 2 or 3 disease, absence of radiotherapy and tumour subtype (hormonal receptor [HR]- / human estrogen receptor [HER]+). AR rates were 1% for triple-negative tumours, 2.8% for HER2-positive tumours, 0.4% for luminal A tumours, 0.9% for HER2-negative luminal B tumours, and 0.5% for HER2-positive luminal B tumours. A simplified score predictive of the occurrence of AR was established. Patients could be divided into three different score groups (p < 0.0001). In multivariate analysis, overall survival was significantly lower in cases of AR (p < 0.0001), age >50, lymphovascular invasion, grade 3 disease, sentinel node (SN) macrometastases, tumour size >20 mm, absence of chemotherapy and triple-negative phenotype. Survival in patients with AR was significantly lower in case of early-onset (2 years) AR (p = 0.017). CONCLUSIONS: Isolated AR is more common in Her2-positive/HR-negative triple-negative tumours with a more severe prognosis in triple-negative and Her2-positive/HR-negative tumours, and represents an independent adverse factor justifying an indication for systemic treatment for AR treatment. However, the benefit of any systemic treatment remains to be proven.
BACKGROUND: The rate of axillary recurrence (AR) after sentinel lymph node biopsy is usually low but few studies investigated its impact on survival. Our aim was to determine the rate and predictive factors of AR in a large cohort of breast cancerpatients and its impact on survival. PATIENTS AND METHODS: From 1999 to 2013, 14,095 patients who underwent surgery for clinically N0 previously untreated breast cancer and had sentinel lymph node biopsy were analysed. A simplified score predictive of AR was established. RESULTS: Median follow-up was 55.2 months. AR was observed in 0.51% of cases, with a median time to onset of 43.4 months. In multivariate analysis, the occurrence of AR was significantly correlated with grade 2 or 3 disease, absence of radiotherapy and tumour subtype (hormonal receptor [HR]- / human estrogen receptor [HER]+). AR rates were 1% for triple-negative tumours, 2.8% for HER2-positive tumours, 0.4% for luminal A tumours, 0.9% for HER2-negative luminal B tumours, and 0.5% for HER2-positive luminal B tumours. A simplified score predictive of the occurrence of AR was established. Patients could be divided into three different score groups (p < 0.0001). In multivariate analysis, overall survival was significantly lower in cases of AR (p < 0.0001), age >50, lymphovascular invasion, grade 3 disease, sentinel node (SN) macrometastases, tumour size >20 mm, absence of chemotherapy and triple-negative phenotype. Survival in patients with AR was significantly lower in case of early-onset (2 years) AR (p = 0.017). CONCLUSIONS: Isolated AR is more common in Her2-positive/HR-negative triple-negative tumours with a more severe prognosis in triple-negative and Her2-positive/HR-negative tumours, and represents an independent adverse factor justifying an indication for systemic treatment for AR treatment. However, the benefit of any systemic treatment remains to be proven.
Authors: Armando E Giuliano; Karla Ballman; Linda McCall; Peter Beitsch; Pat W Whitworth; Peter Blumencranz; A Marilyn Leitch; Sukamal Saha; Monica Morrow; Kelly K Hunt Journal: Ann Surg Date: 2016-09 Impact factor: 12.969
Authors: Jong Yun Baek; Doo Ho Choi; Won Park; Haeyoung Kim; Won Kyung Cho; Gyu Sang Yoo Journal: J Breast Cancer Date: 2020-12-08 Impact factor: 3.588