Naslov
Clinical Impact of Sentinel Node Biopsy after Preoperative Systemic Treatment in Luminal B, HER-2 Positive and Triple Negative Breast Cancer Patients with Initially Involved Axillary Lymph Node(S)

Autori
Car Peterko, Ana ; Avirović, Manuela ; Mance, Diana ; 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
Preoperative systemic treatment, breast carcinoma, sentinel lymph node

Sažetak
Background: According to current NCCN guidelines and consensus achieved by panel of experts in St. Gallen in 2017, sentinel lymph node biopsy (SLNB) is recommended procedure for axillary staging after neoadjuvant systemic treatment (NAST) for all breast cancer patients presenting in clinical stage T1-3N0M0 at the time of the surgery, including those initially node-positive patients who achieved complete clinical axillary remission following NAST. Due to high rate of false negative results in initial trials and consequently the concerns about oncological safety of the SLNB procedure after NAST, in majority breast cancer centers in Croatia axillary lymph node dissection (ALND) remained preferred procedure for axillary staging after NAST in initially node-positive breast cancer patients regardless the treatment response. In Clinical Hospital Center Rijeka, SLNB after NAST is implemented in clinical practice in May 2017. So far, any negative clinical impact of the procedure was not noticed. To evaluate this observation and to contribute with the acceptance of the procedure we have initiated a prospective, observational clinical trial (registered and public available on www.clinicaltrials.gov ID:NCT03719833). Materials and Methods: All breast cancer patients eligible for this trial and submitted to surgery in Clinical Hospital Center Rijeka in the period from September 2018 till May 2022. would be included in this trial and divided in three groups according to the study protocol. Patients in clinical stage T1N0M0 would be assigned to group 1 and submitted to surgery followed by adjuvant oncological treatment. Patients assigned to groups 2 (cT2-3cN0M0) and 3 (cT1-3cN12M0) would undergo NAST before surgical procedure. SLNB would be performed for all patients presenting with cN0 preoperatively. Postoperatively, in 5 year follow up period, all patients would be periodically monitored for primary outcome measures defined by this trial, e.g. appearance of local and regional recurrence, progression of disease and survival. Results: Results regarding regional recurrence rate and regional recurrence free survival would be compared among this three groups. Addi- tionally, all results gained in this trial for sentinel negative group 3 patients would be compared to the same outcome measures of equal stage group of patients treated in our institution in period from 2011 till 2014, e.g. all submitted to ALND. Conclusions: The aim of this trial is to provide enough evidence that SLNB after NAST is not inferior to ALND in achieving regional control of disease, that the procedure does not alter the clinical outcomes and that ALND can be safely omitted in all sentinel node negative patients following NAST including those 40-60% initially node-positive that switch to node-negative by preoperative systemic oncological treatment.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA