Antonio Esgueva1, Christian Siso2, Martin Espinosa-Bravo2, Carolina Sobrido3, Ignacio Miranda4, Juan P Salazar4, Isabel T Rubio1. 1. Department of Breast Surgical Oncology, Clinica Universidad de Navarra, Universidad de Navarra, Madrid, Spain. 2. Department of Breast Surgical Oncology, Hospital Universitario Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain. 3. Breast Imaging Unit, Department of Radiology, Clinica Universidad de Navarra, Universidad de Navarra, Madrid, Spain. 4. Breast Imaging Unit, Department of Radiology, Hospital Universitario Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
Abstract
INTRODUCTION: Breast conservative surgery (BCS) and sentinel lymph node biopsy (SLNB) after neoadjuvant treatment (NAT) is safe and effective for selected patients. This aim of this study is to evaluate the impact of anatomic site of response on outcomes and to assess the real population who may benefit from nonsurgical approaches after NAT. MATERIAL AND METHODS: From a prospectively maintained database, patients with T1-4 N0-2 breast cancer undergoing NAT were identified. Clinicopathological and survival rates were compared in relation to response and anatomic site of response. RESULTS: Six hundred and forty-six patients were included in the study. Pathologic complete response (pCR) was an independent factor for BCS and SLN. HER2 positive and TN tumors with cN0 achieving a breast pCR remain ypN0 (p = .002). Residual axillary disease was associated with breast residual tumor (p = .05) and subtype (p = .001). With a median follow up of 35.25 months, patients with any pCR had improved survival when compared with partial response, but not significant differences between pCR, axillary pCR, or breast pCR. CONCLUSION: Achieving a pCR increases BCS and SLN. In selected subgroups, sparing any axillary surgery after NAT maybe feasible. In cN+ patients, any pCR was associated with survival, but not the anatomic site of response.
INTRODUCTION: Breast conservative surgery (BCS) and sentinel lymph node biopsy (SLNB) after neoadjuvant treatment (NAT) is safe and effective for selected patients. This aim of this study is to evaluate the impact of anatomic site of response on outcomes and to assess the real population who may benefit from nonsurgical approaches after NAT. MATERIAL AND METHODS: From a prospectively maintained database, patients with T1-4 N0-2 breast cancer undergoing NAT were identified. Clinicopathological and survival rates were compared in relation to response and anatomic site of response. RESULTS: Six hundred and forty-six patients were included in the study. Pathologic complete response (pCR) was an independent factor for BCS and SLN. HER2 positive and TN tumors with cN0 achieving a breast pCR remain ypN0 (p = .002). Residual axillary disease was associated with breast residual tumor (p = .05) and subtype (p = .001). With a median follow up of 35.25 months, patients with any pCR had improved survival when compared with partial response, but not significant differences between pCR, axillary pCR, or breast pCR. CONCLUSION: Achieving a pCR increases BCS and SLN. In selected subgroups, sparing any axillary surgery after NAT maybe feasible. In cN+ patients, any pCR was associated with survival, but not the anatomic site of response.
Authors: Fernando A Angarita; Robert Brumer; Matthew Castelo; Nestor F Esnaola; Stephen B Edge; Kazuaki Takabe Journal: Cancers (Basel) Date: 2022-09-20 Impact factor: 6.575
Authors: Maggie Banys-Paluchowski; Maria Luisa Gasparri; Jana de Boniface; Oreste Gentilini; Elmar Stickeler; Steffi Hartmann; Marc Thill; Isabel T Rubio; Rosa Di Micco; Eduard-Alexandru Bonci; Laura Niinikoski; Michalis Kontos; Guldeniz Karadeniz Cakmak; Michael Hauptmann; Florentia Peintinger; David Pinto; Zoltan Matrai; Dawid Murawa; Geeta Kadayaprath; Lukas Dostalek; Helidon Nina; Petr Krivorotko; Jean-Marc Classe; Ellen Schlichting; Matilda Appelgren; Peter Paluchowski; Christine Solbach; Jens-Uwe Blohmer; Thorsten Kühn Journal: Cancers (Basel) Date: 2021-03-29 Impact factor: 6.639