Young-Joon Kang1, Wonshik Han1, Soojin Park2, Ji Young You2, Ha Woo Yi3, Sungmin Park3, Sanggeun Nam4, Joo Heung Kim4, Keong Won Yun5, Hee Jeong Kim5, Sei Hyun Ahn5, Seho Park4, Jeong Eon Lee3, Eun Sook Lee2, Dong-Young Noh1, Jong Won Lee6. 1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. 2. Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea. 3. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 4. Department of Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea. 5. Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Korea. 6. Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Korea. jjjongwr@hanmail.net.
Abstract
PURPOSE: Many breast cancer patients with positive axillary lymph nodes achieve complete node remission after neoadjuvant chemotherapy. The usefulness of sentinel lymph node biopsy in this situation is uncertain. This study evaluated the outcomes of sentinel biopsy-guided decisions in patients who had conversion of axillary nodes from clinically positive to negative following neoadjuvant chemotherapy. METHODS: We reviewed the records of 1247 patients from five hospitals in Korea who had breast cancer with clinically axillary lymph node-positive status and negative conversion after neoadjuvant chemotherapy, between 2005 and 2012. Patients who underwent axillary operations with sentinel biopsy-guided decisions (Group A) were compared with patients who underwent complete axillary lymph node dissection without sentinel lymph node biopsy (Group B). Axillary node recurrence and distant recurrence-free survival were compared. RESULTS: There were 428 cases in Group A and 819 in Group B. Kaplan-Meier analysis showed that recurrence-free survivals were not significantly different between Groups A and B (4-year axillary recurrence-free survival: 97.8 vs. 99.0%; p = 0.148). Multivariate analysis also indicated the two groups had no significant difference in axillary and distant recurrence-free survival. CONCLUSIONS: For breast cancer patients who had clinical conversion of axillary lymph nodes from positive to negative following neoadjuvant chemotherapy, sentinel biopsy-guided axillary surgery, and axillary lymph node dissection without sentinel lymph node biopsy had similar rates of recurrence. Thus, sentinel biopsy-guided axillary operation in breast cancer patients who have clinically axillary lymph node positive to negative conversion following neoadjuvant chemotherapy is a useful strategy.
PURPOSE: Many breast cancerpatients with positive axillary lymph nodes achieve complete node remission after neoadjuvant chemotherapy. The usefulness of sentinel lymph node biopsy in this situation is uncertain. This study evaluated the outcomes of sentinel biopsy-guided decisions in patients who had conversion of axillary nodes from clinically positive to negative following neoadjuvant chemotherapy. METHODS: We reviewed the records of 1247 patients from five hospitals in Korea who had breast cancer with clinically axillary lymph node-positive status and negative conversion after neoadjuvant chemotherapy, between 2005 and 2012. Patients who underwent axillary operations with sentinel biopsy-guided decisions (Group A) were compared with patients who underwent complete axillary lymph node dissection without sentinel lymph node biopsy (Group B). Axillary node recurrence and distant recurrence-free survival were compared. RESULTS: There were 428 cases in Group A and 819 in Group B. Kaplan-Meier analysis showed that recurrence-free survivals were not significantly different between Groups A and B (4-year axillary recurrence-free survival: 97.8 vs. 99.0%; p = 0.148). Multivariate analysis also indicated the two groups had no significant difference in axillary and distant recurrence-free survival. CONCLUSIONS: For breast cancerpatients who had clinical conversion of axillary lymph nodes from positive to negative following neoadjuvant chemotherapy, sentinel biopsy-guided axillary surgery, and axillary lymph node dissection without sentinel lymph node biopsy had similar rates of recurrence. Thus, sentinel biopsy-guided axillary operation in breast cancerpatients who have clinically axillary lymph node positive to negative conversion following neoadjuvant chemotherapy is a useful strategy.
Authors: Hee Jeong Kim; Woo Chul Noh; Eun Sook Lee; Yong Sik Jung; Lee Su Kim; Wonshik Han; Seok Jin Nam; Gyung -Yub Gong; Hwa Jung Kim; Sei Hyun Ahn Journal: Breast Cancer Res Date: 2020-05-27 Impact factor: 6.466
Authors: Hee Jun Choi; Isaac Kim; Emad Alsharif; Sungmin Park; Jae-Myung Kim; Jai Min Ryu; Seok Jin Nam; Seok Won Kim; Jonghan Yu; Se Kyung Lee; Jeong Eon Lee Journal: J Breast Cancer Date: 2018-11-23 Impact factor: 3.588