van Roozendaal Lori M, Smit Leonie H M, Duijsens Gaston H N M, de Vries Bart, Siesling Sabine, Lobbes Marc B I, de Boer Maaike, de Wilt Johannes H W, Smidt Marjolein L
Department of Surgical Oncology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
Breast Cancer Res Treat. 2016 Apr;156(3):465-472. doi: 10.1007/s10549-016-3757-4. Epub 2016 Mar 25.
Triple-negative breast cancer is associated with early recurrence and low survival rates. Several trials investigate the safety of a more conservative approach of axillary treatment in clinically T1-2N0 breast cancer. Triple-negative breast cancer comprises only 15 % of newly diagnosed breast cancers, which might result in insufficient power for representative results for this subgroup. We aimed to provide a nationwide overview on the occurrence of (regional) recurrences in triple-negative breast cancer patients with a clinically T1-2N0 status. For this cohort study, 2548 women diagnosed between 2005 and 2008 with clinically T1-2N0 triple-negative breast cancer were selected from the Netherlands Cancer Registry. Follow-up data until 2014 were analyzed using Kaplan-Meier. Sentinel lymph node biopsy was performed in 2486 patients, and (completion) axillary lymph node dissection in 562 patients. Final pathologic nodal status was pN0 in 78.5 %, pN1mi in 4.5 %, pN1 in 12.3 %, pN2-3 in 3.6 %, and pNx in 1.1 %. During a follow-up of 5 years, regional recurrence occurred in 2.9 %, local recurrence in 4.2 % and distant recurrence in 12.2 %. Five-year disease-free survival was 78.7 %, distant disease-free survival 80.5 %, and 5-year overall survival 82.3 %. Triple-negative clinically T1-2N0 breast cancer patients rarely develop a regional recurrence. Their disease-free survival is more threatened by distant recurrence, affecting their overall survival. Consequently, it seems justified to include triple-negative breast cancer patients in randomized controlled trials investigating the safety of minimizing axillary staging and treatment.
三阴性乳腺癌与早期复发及低生存率相关。多项试验探讨了在临床T1-2N0期乳腺癌中采用更保守的腋窝治疗方法的安全性。三阴性乳腺癌仅占新诊断乳腺癌的15%，这可能导致该亚组代表性结果的检验效能不足。我们旨在提供一份关于临床T1-2N0期三阴性乳腺癌患者（区域）复发情况的全国性概述。对于这项队列研究，从荷兰癌症登记处选取了2548名在2005年至期间被诊断为临床T1-2N0期三阴性乳腺癌的女性。使用Kaplan-Meier法分析了截至2014年的随访数据。2486例患者进行了前哨淋巴结活检，562例患者进行了（根治性）腋窝淋巴结清扫。最终病理淋巴结状态为pN0的占78.5%，pN1mi的占4.5%，pN1的占12.3%，pN2-3的占3.6%，pNx的占1.1%。在5年的随访期间，区域复发率为2.9%，局部复发率为4.2%，远处复发率为12.2%。5年无病生存率为78.7%，远处无病生存率为80.5%，5年总生存率为82.3%。临床T1-2N0期三阴性乳腺癌患者很少发生区域复发。远处复发对其无病生存的威胁更大，进而影响其总生存。因此，将三阴性乳腺癌患者纳入研究腋窝分期和治疗最小化安全性的随机对照试验似乎是合理的。 2008年诊断为临床T1-2N0期三阴性乳腺癌的女性。使用Kaplan-Meier法分析了截至2014年的随访数据。2486例患者进行了前哨淋巴结活检，562例患者进行了（根治性）腋窝淋巴结清扫。最终病理淋巴结状态为pN0的占78.5%，pN1mi的占4.5%，pN1的占12.3%，pN2-3的占3.6%，pNx的占1.1%。在5年的随访期间，区域复发率为2.9%，局部复发率为4.2%，远处复发率为12.2%。5年无病生存率为78.7%，远处无病生存率为80.5%，5年总生存率为82.3%。临床T1-2N0期三阴性乳腺癌患者很少发生区域复发。远处复发对其无病生存的威胁更大，进而影响其总生存。因此，将三阴性乳腺癌患者纳入研究腋窝分期和治疗最小化安全性的随机对照试验似乎是合理的。 2008年诊断为临床T1-2N0期三阴性乳腺癌的女性。使用Kaplan-Meier法分析了截至2014年的随访数据。2486例患者进行了前哨淋巴结活检，562例患者进行了（根治性）腋窝淋巴结清扫。最终病理淋巴结状态为pN0的占78.5%，pN1mi的占4.5%，pN1的占12.3%，pN2-3的占3.6%，pNx的占1.1%。在5年的随访期间，区域复发率为2.9%，局部复发率为4.2%，远处复发率为12.2%。5年无病生存率为78.7%，远处无病生存率为80.5%，5年总生存率为
