J Breast Dis.  2020 Dec;8(2):121-128. 10.14449/jbd.2020.8.2.121.

Axillary Sampling as an Alternative Option for Complete Nodal Response in Triple Negative and HER2 Type Breast Cancer Patients after Neoadjuvant Chemotherapy

Affiliations
  • 1Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
  • 2Department of Hemato-Oncology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
  • 3Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
  • 4Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
  • 5Department of Radiation Oncology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
  • 6Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea

Abstract

Purpose
In patients with locally advanced breast cancer, neoadjuvant chemotherapy is widely used. It has a distinct advantage in the downstaging of the primary tumor and provides important information about treatment response. With its increasing usage, concerns over the appropriate management of the axilla have emerged. In this study, we compared oncological outcomes of conventional axillary lymph node dissection (ALND) over axillary sampling (AS) with radiotherapy (RT) in patients who received neoadjuvant chemotherapy.
Methods
In this retrospective study, we included female patients with triple negative breast cancer (TNBC) and HER2 type breast cancer who underwent breast and axillary surgery after neoadjuvant chemotherapy between May 2011 to December 2016. A total of 89 patients’ medical records were eligible for analysis. We defined AS as removal of at least four axillary lymph nodes located near the sentinel lymph nodes without full exposure of the axillary vein, long thoracic nerve, and thoracodorsal nerve.
Results
The median follow-up period was 47.00 months. The disease-free survival was 69.66 months in the AS with RT group and 69.02 months in the ALND group (p=0.280). The invasive disease-free survival was 75.16 months in the AS with RT group and 78.44 months in the ALND group (p=0.218).
Conclusion
AS with radiotherapy might be a feasible surgical option in patients with TNBC and HER2 type breast cancer after neoadjuvant chemotherapy.

Keyword

Breast neoplasms; Lymph node excision; Neoadjuvant therapy
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