Sabrina Kahler-Ribeiro-Fontana1, Eleonora Pagan2, Francesca Magnoni3, Elisa Vicini3, Consuelo Morigi3, Giovanni Corso4, Mattia Intra3, Fiorella Canegallo3, Silvia Ratini3, Maria Cristina Leonardi5, Eliana La Rocca6, Vincenzo Bagnardi2, Emilia Montagna7, Marco Colleoni7, Giuseppe Viale8, Luca Bottiglieri9, Chiara Maria Grana10, Jorge Villanova Biasuz11, Paolo Veronesi4, Viviana Galimberti3. 1. Division of Breast Cancer Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy; Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. Electronic address: sabrina.fontana@ieo.it. 2. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy. 3. Division of Breast Cancer Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy. 4. Division of Breast Cancer Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy; Faculty of Medicine, University of Milan, Italy. 5. Division of Radiotherapy, IEO, European Institute of Oncology, IRCCS, Milan, Italy. 6. Division of Radiotherapy, IEO, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Italy. 7. Division of Division of Medical Senology, IEO, European Institute of Oncology, IRCCS, Milan, Italy. 8. Department of Pathology, IEO, European Institute of Oncology, Milan, IRCCS, Italy; Faculty of Medicine, University of Milan, Italy. 9. Department of Pathology, IEO, European Institute of Oncology, Milan, IRCCS, Italy. 10. Division of Nuclear Medicine, IEO, European Institute of Oncology, IRCCS, Milan, Italy. 11. Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Abstract
INTRODUCTION: In patients with positive lymph nodes (cN+) prior to neoadjuvant treatment (NAT), which convert to a clinically negative axilla (cN0) after treatment, the use of sentinel node biopsy (SNB) is still debatable, since the false-negative rate (FNR) is significantly high (12.6-14.2%). The objective of this retrospective mono-institutional study, with a long follow-up, aimed to evaluate the outcome in patients undergoing NAT who remained or converted to cN0 and received SNB independent of target axillary dissection (TAD) or the removal of at least 3 sentinel nodes (SNs). METHODS: This study analyzed 688 consecutive cT1-3, cN0/1/2 patients, operated at the European Institute of Oncology, Milan, from 2000 to 2015 who became or remained cN0 after NAT and underwent SNB with a least one SN found. Axillary dissection (AD) was not performed if the SN was negative. Nodal radiotherapy (RT) was not mandatory. RESULTS: Axillary failure occurred in 1.8% of the initially cN1/2 patients and in 1.5% of the initially cN0 patients. After a median follow-up of 9.2 years (IQR 5.3-12.3), the 5- and 10-year overall survival (OS) were 91.3% (95% CI, 88.8-93.2) and 81.0% (95% CI, 77.2-84.2) in the whole cohort, 92.0% (95% CI, 89.0-94.2) and 81.5% (95% CI, 76.9-85.2) in those initially cN0, 89.8% (95% CI, 85.0-93.2) and 80.1% (95% CI, 72.8-85.7) in those initially cN1/2. CONCLUSION: The 10-year follow-up confirmed our preliminary data that the use of standard SNB is acceptable in cN1/2 patients who become cN0 after NAT and will not translate into a worse outcome.
INTRODUCTION: In patients with positive lymph nodes (cN+) prior to neoadjuvant treatment (NAT), which convert to a clinically negative axilla (cN0) after treatment, the use of sentinel node biopsy (SNB) is still debatable, since the false-negative rate (FNR) is significantly high (12.6-14.2%). The objective of this retrospective mono-institutional study, with a long follow-up, aimed to evaluate the outcome in patients undergoing NAT who remained or converted to cN0 and received SNB independent of target axillary dissection (TAD) or the removal of at least 3 sentinel nodes (SNs). METHODS: This study analyzed 688 consecutive cT1-3, cN0/1/2 patients, operated at the European Institute of Oncology, Milan, from 2000 to 2015 who became or remained cN0 after NAT and underwent SNB with a least one SN found. Axillary dissection (AD) was not performed if the SN was negative. Nodal radiotherapy (RT) was not mandatory. RESULTS:Axillary failure occurred in 1.8% of the initially cN1/2patients and in 1.5% of the initially cN0 patients. After a median follow-up of 9.2 years (IQR 5.3-12.3), the 5- and 10-year overall survival (OS) were 91.3% (95% CI, 88.8-93.2) and 81.0% (95% CI, 77.2-84.2) in the whole cohort, 92.0% (95% CI, 89.0-94.2) and 81.5% (95% CI, 76.9-85.2) in those initially cN0, 89.8% (95% CI, 85.0-93.2) and 80.1% (95% CI, 72.8-85.7) in those initially cN1/2. CONCLUSION: The 10-year follow-up confirmed our preliminary data that the use of standard SNB is acceptable in cN1/2patients who become cN0 after NAT and will not translate into a worse outcome.
Authors: Erika Barbieri; Damiano Gentile; Alberto Bottini; Andrea Sagona; Wolfgang Gatzemeier; Agnese Losurdo; Bethania Fernandes; Corrado Tinterri Journal: Eur J Breast Health Date: 2021-10-04
Authors: Giacomo Montagna; Minna K Lee; Varadan Sevilimedu; Andrea V Barrio; Monica Morrow Journal: Ann Surg Oncol Date: 2022-07-28 Impact factor: 4.339
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