Journals / Eurasian Journal of Medical Investigation / 2022 / Cilt: 6 - Sayı: 2

In Which Luminal Breast Cancers Might Neoadjuvant Chemotherapy Be Appropriate to Achieve a Pathological Complete Response in Axillary Lymph Nodes?

Pages
184–189
Publication Date
2022-10-12
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Based on the findings of our study, we think it would be appropriate to use NAC in patients with luminal BC with the goal of reducing axillary surgery in the presence of cN1, grade 3 tumors.

📌 3 Key Takeaways

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Objective & Hypothesis:Objectives: In this study, we aimed to evaluate in which luminal/human epidermal growth factor receptor 2 negative (her2-) breast cancers (BCs) would be achieved complete pathological response in axillary lymph nodes with neoadjuvant chemotherapy (ypN0).
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Key Findings & Data:Methods: We retrospectively analyzed 66 patients with luminal/her2- BC who were operated after neoadjuvant chemotherapy (NAC).
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Conclusion & Impact:Based on the findings of our study, we think it would be appropriate to use NAC in patients with luminal BC with the goal of reducing axillary surgery in the presence of cN1, grade 3 tumors.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objectives: In this study, we aimed to evaluate in which luminal/human epidermal growth factor receptor 2 negative (her2-) breast cancers (BCs) would be achieved complete pathological response in axillary lymph nodes with neoadjuvant chemotherapy (ypN0). Methods: We retrospectively analyzed 66 patients with luminal/her2- BC who were operated after neoadjuvant chemotherapy (NAC). We evaluated the predictive factors for ypN0 after NAC. Results: We detected ypT0 in 15.2% of the patients and ypN0 in 31.8%. Univariate analysis indicated that grade, cN stage, and anatomical stage were significant predictors of ypN0. According to the multivariate analysis, grade was the only significant factor in predicting ypN0 independently of other factors (p=0.037). Considering the grades of cN1 patients, the ypN0 rate was 2/18 (11.1%) for grade 1-2 and 7/10 (70%) for grade 3 (p=0.01). Conclusion: In the presence of cN1 axillary lymph nodes, the decision of NAC can be challenging for clinicians in luminal BC patients, especially with no clear indication for NAC. Nowadays, if ycN0 is provided after NAC in cN1 cases, methods such as sentinel lymph node dissection/targeted axillary dissection are more commonly used for axillary staging. Based on the findings of our study, we think it would be appropriate to use NAC in patients with luminal BC with the goal of reducing axillary surgery in the presence of cN1, grade 3 tumors.

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Cite This Article

ŞİMŞEK, E. T., ATAĞ, E., ÇOBAN, E., SARI, M., GÜRLEYİK, G. (2022). In Which Luminal Breast Cancers Might Neoadjuvant Chemotherapy Be Appropriate to Achieve a Pathological Complete Response in Axillary Lymph Nodes?. Eurasian Journal of Medical Investigation, Cilt: 6 - Sayı: 2, 184–189. https://ajindex.com/articles/508518

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References (12)

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209–49
  2. Comprehensive molecular portraits of human breast tumours. Nature 2012;490:61–70
  3. Voduc KD, Cheang MCU, Tyldesley S, Gelmon K, Nielsen TO, Kennecke H. Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol 2010;28:1684–91
  4. Howlader N, Cronin KA, Kurian AW, Andridge R. Differences in breast cancer survival by molecular subtypes in the United States. Cancer Epidemiol Biomarkers Prev 2018;27:619–26
  5. Spring LM, Fell G, Arfe A, Sharma C, Greenup R, Reynolds KL, et al. Pathologic complete response after neoadjuvant chemotherapy and impact on breast cancer recurrence and survival: a comprehensive meta-analysis. Clin Cancer Res 2020;26:2838–48
  6. Masuda N, Lee SJ, Ohtani S, Im YH, Lee ES, Yokota I, et al. Adjuvant capecitabine for breast cancer after preoperative chemotherapy. N Engl J Med 2017;376:2147–59
  7. Von Minckwitz G, Huang C-S, Mano MS, Loibl S, Mamounas EP, Untch M, et al. Trastuzumab emtansine for residual invasive HER2-positive breast cancer. N Engl J Med 2019;380:617–28
  8. El Hage Chehade H, Headon H, El Tokhy O, Heeney J, Kasem A, Mokbel K. Is sentinel lymph node biopsy a viable alternative to complete axillary dissection following neoadjuvant chemotherapy in women with node-positive breast cancer at diagnosis? An updated meta-analysis involving 3,398 patients. Am J Surg 2016;212:969–81
  9. Gurleyik G, Aksu SA, Aker F, Tekyol KK, Tanrikulu E, Gurleyik E. Targeted axillary biopsy and sentinel lymph node biopsy for axillary restaging after neoadjuvant chemotherapy. Ann Surg Treat Res 2021;100:305–12
  10. Hammond MEH, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 2010;28:2784–95
  11. Wolff AC, Hammond ME, Hicks DG, Dowsett M, McShane LM, Allison KH, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol 2013;31:3997–4013
  12. NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. Version 8.2021. Available at: http