Naslov
Clinical Impact of Sentinel Lymph Node Biopsy after Neoadjuvant Treatment in Breast Cancer Patients with Initially Involved Axillary Lymph Nodes (Single-Center Experience)

Autori
Car Peterko, Ana ; Avirović, Manuela ; Mance, Diana ; Valković Zujić, Petra ; Belac Lovasić Ingrid ; Lovasić, Franjo

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Skup
39th Congress of the European Society of Surgical Oncology (ESSO 39)

Mjesto i datum
Rotterdam, Nizozemska, 09.10.2019. - 11.10.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Neoadjuvant therapy, breast carcinoma, sentinel lymph node

Sažetak
Background: Due to consensus conference in St. Gallen and updated NCCN guidelines for breast cancer treatment, in Clinical Hospital Center (CHC)Rijeka, in May 2017. sentinel lymph node biopsy (SLNB) was introduced in clinical practice for breast cancer patients that achieve complete clinical axillary remission after preoperative oncological treatment. Patients and methods: All breast cancer patients, with operable disease, submitted to systemic treatment prior to surgery, performed in CHC Rijeka in period from May 2016 till May 2018, were involved in this trial. Within surgical procedure SLNB or axillary lymph node dissection (ALND) was made. In first postoperative year prevalence of locoregional and distant relapse were observed. Results: From 65 patients initially involved in this trial, 17 patients were presented with uninvolved axilla (group 1) at the time of diagnosis and 48 patients with clinically involved lymph nodes (group 2). In group 1, at the time of the surgery 6 ALND and 11 SLNB was done. In the first postoperative year neither one case of locoregional and distant recurrence was observed in this group. Therefore, our retrospective analysis and further results apply to group 2. Complete pathological axillary remission (ypN0/ ypN0(sn)) was achieved by 45.83% patients. In 40% of ypN0 patients SLNB was made at the time of the surgery and for 60% of patients ALND, respectively. Neither one case of locoregional relapse was documented for ypN0 patients regardless the extent of surgical procedure (SLNB vs. ALND)and there was no statistically significant difference in prevalence of distant recurrence among those two groups (proportion difference test, p1⁄40.788). Nevertheless, statistically significant higher prevalence of distant recurrence (proportion difference test, p1⁄40.0419) was observed for patients that did not achieved complete axillary response following preoperative treatment, although ALND was made for all these patients. Prevalence of locoregional relapse among ypN0 patients and patients who did not shift to ypN0 following neoadjuvant treatment was at borderline of statistically significance (proportion difference test, p1⁄40.057), presumably caused by small sample and short follow up period. We also observed increasing trend of implementation preoperative systemic treatment for operable tumors (82.6% increment in one year). Conclusion: For breast cancer patients, that achieved complete clinical axillary remission after preoperative systemic treatment, SLNB is reliable alternative of ALND for locoregional control of disease. Axillary lymph node status after neoadjuvant treatment is far more relevant predictor of prognose than axillary lymph node status at the beginning of the treatment. These preliminary results would be reevaluate by ongoing prospective trial (protocol available on www.clinicaltrials.gov, ID:NCT03719833).

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA