Department of Radiology, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
Breast J. 2019 Mar;25(2):196-201. doi: 10.1111/tbj.13192. Epub 2019 Feb 3.
To evaluate predictive factors for residual metastatic axillary lymph node (ALN) disease in patients with negative imaging findings after neo-adjuvant chemotherapy (NAC) for breast cancer. From January 2011 to December 2015, 206 patients underwent imaging including ultrasonography, MRI, and PET/CT for restaging the axilla after NAC. Data collected included preoperative information regarding histologic grade, hormone receptor (HR) status, and human epidermal growth factor receptor 2 (HER2) status. Multivariate logistic regression analysis was performed to compare patients with and without residual metastatic ALN disease among patients who showed negative imaging findings after NAC. Of the 181 and 25 patients with initially node-positive and node-negative disease, 131 (72.4%) and 23 (92.0%), respectively, showed negative imaging findings after NAC. Among these 131 and 23 patients, 53 (40.5%) and two patients (8.7%), respectively, had residual metastatic ALN disease. Low to moderate tumor grade (odds ratio [OR] = 5.2, P = 0.009), positive HR status (OR = 6.6, P = 0.003), and negative HER2 status (OR = 2.6, P = 0.048) were associated with residual metastatic ALN disease. Low to moderate histologic grade, positive HR status, and negative HER2 status may serve as predictors of residual metastatic ALN disease in patients with negative imaging findings after NAC for breast cancer.
评估新辅助化疗（NAC）后乳腺癌阴性影像学发现患者残留转移性腋窝淋巴结（ALN）疾病的预测因素。从 2011 年 1 月至 2015 年 12 月，206 例患者接受了包括超声、MRI 和 PET/CT 在内的影像学检查，以对 NAC 后腋窝进行重新分期。收集的术前数据包括组织学分级、激素受体（HR）状态和人表皮生长因子受体 2（HER2）状态。多变量逻辑回归分析用于比较 NAC 后影像学阴性发现的患者中有无残留转移性 ALN 疾病的患者。在最初淋巴结阳性和淋巴结阴性的 181 例和 25 例患者中，131 例（72.4%）和 23 例（92.0%）分别在 NAC 后显示阴性影像学发现。在这 131 例和 23 例患者中，53 例（40.5%）和 2 例患者（8.7%）分别有残留转移性 ALN 疾病。低至中度肿瘤分级（比值比 [OR] = 5.2，P = 0.009）、HR 状态阳性（OR = 6.6，P = 0.003）和 HER2 状态阴性（OR = 2.6，P = 0.048）与残留转移性 ALN 疾病相关。低至中度组织学分级、HR 状态阳性和 HER2 状态阴性可能是 NAC 后乳腺癌阴性影像学发现患者残留转移性 ALN 疾病的预测因素。
