Amparo Garcia-Tejedor1, Catalina Falo2, Cecilia Quetglas3, Teresa Soler4, Belen Marqueta3, Raul Ortega5, Miguel Gil-Gil2, Sonia Pernas2, Eulalia Fernandez-Montolí3, Maria J Pla3, Anna Guma5, Maite Bajen6, Ana Benitez6, Arantxa Eraso7, Miriam Campos3, Anna Petit4, Jordi Ponce3. 1. Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain. Electronic address: agarciat@bellvitgehospital.cat. 2. Department of Oncology, Multidisciplinary Breast Cancer Unit, Institut Català d'Oncología, Barcelona, Spain. 3. Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain. 4. Department of Pathology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain. 5. Department of Radiology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain. 6. Department of Nuclear Medicine, Multidisciplinary Breast Cancer Unit Hospital, Universitari Bellvitge, Idibell, Barcelona, Spain. 7. Department of Oncological Radiotherapy, Multidisciplinary Breast Cancer Unit, Institut Català d'Oncología, Barcelona, Spain.
Abstract
BACKGROUND AND OBJECTIVE: It remains controversial whether sentinel lymph node biopsy (SLNB) should be performed before or after neoadjuvant therapy (NAT). We aimed to evaluate the feasibility and accuracy of SLNB before NAT at a single institution, and to determine its relation to patient prognosis. METHODS: A prospective study of T1c-T2-T3 N0 breast cancer patients, after ultrasound examination, who underwent SLNB prior to NAT. Overall, disease-specific and disease-free survival were calculated by Kaplan-Meier curves. RESULTS: SLNB before NAT was performed in 123 patients from December 2006 to May 2014. The identification rate was 100%. SLNB was positive in 42.3% of cases (27.6% macrometastases). NAT was chemotherapy in 88.6% of cases and endocrine-therapy in 11.4%. Lymphadenectomy was avoided in 72.4% of cases. Median follow-up was 40 months (range 8-100). Overall and disease-free survival was 90.2% and 88.6% respectively.SLN involvement was not related to patient outcome (p 0.72); however there were significant differences in survival according to molecular-like subtypes (p < 0.025) and NAT response (p < 0.0001). CONCLUSIONS: SLNB prior to NAT is an accurate method of axillary staging associated with a high identification rate. It avoided lymphadenectomy in more than 70% of patients. SLN involvement did not worsen the prognosis in our cohort.
BACKGROUND AND OBJECTIVE: It remains controversial whether sentinel lymph node biopsy (SLNB) should be performed before or after neoadjuvant therapy (NAT). We aimed to evaluate the feasibility and accuracy of SLNB before NAT at a single institution, and to determine its relation to patient prognosis. METHODS: A prospective study of T1c-T2-T3 N0 breast cancerpatients, after ultrasound examination, who underwent SLNB prior to NAT. Overall, disease-specific and disease-free survival were calculated by Kaplan-Meier curves. RESULTS: SLNB before NAT was performed in 123 patients from December 2006 to May 2014. The identification rate was 100%. SLNB was positive in 42.3% of cases (27.6% macrometastases). NAT was chemotherapy in 88.6% of cases and endocrine-therapy in 11.4%. Lymphadenectomy was avoided in 72.4% of cases. Median follow-up was 40 months (range 8-100). Overall and disease-free survival was 90.2% and 88.6% respectively.SLN involvement was not related to patient outcome (p 0.72); however there were significant differences in survival according to molecular-like subtypes (p < 0.025) and NAT response (p < 0.0001). CONCLUSIONS: SLNB prior to NAT is an accurate method of axillary staging associated with a high identification rate. It avoided lymphadenectomy in more than 70% of patients. SLN involvement did not worsen the prognosis in our cohort.
Authors: David Krug; René Baumann; Wilfried Budach; Jürgen Dunst; Petra Feyer; Rainer Fietkau; Wulf Haase; Wolfgang Harms; Thomas Hehr; Marc D Piroth; Felix Sedlmayer; Rainer Souchon; Frederik Wenz; Rolf Sauer Journal: Strahlenther Onkol Date: 2018-07-04 Impact factor: 3.621