University of Health Science, Ankara Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
Breast J. 2022 Jul 30;2022:8284814. doi: 10.1155/2022/8284814. eCollection 2022.
Luminal A breast cancer has a good prognosis and the criteria for adjuvant and neoadjuvant chemotherapy (NAC) are not clear. The aim of this study was to present our results of upfront surgery and long-term survival in luminal A tumors as well as the rates of protection from axillary dissection. . 271 Luminal A breast cancer patients who had operated at our center were evaluated retrospectively. In patients with 2 or less sentinel lymph node (SLN) positivity who did not receive neoadjuvant therapy and underwent breast-conserving surgery, axillary lymph node dissection was omitted (OAD). Axillary lymph node dissection (ALND) was performed in patients with positive SLN who did not meet these criteria (axillary dissection after sentinel/ADAS).
While Sentinel Lymph Node Biopsy (SLNB) was performed in 212 (77.9%) patients, SLNB + Axillary Dissection (AD) was performed in 58 (21.3%), and direct axillary dissection was performed in 1 (0.8%) patient. OAD was applied to 18 (23.6%) of the positive patients. . ALND rates are still strikingly high in luminal A breast cancer treatment, despite the disease's milder clinical course. In order to avoid complications of axillary dissection, patients should be considered for NAC as much as possible. Novel neoadjuvant or other therapy options are also required.
腔 A 型乳腺癌预后良好，辅助和新辅助化疗（NAC）的标准尚不明确。本研究旨在报告我们在腔 A 型肿瘤中进行初始手术和长期生存的结果，以及避免腋窝清扫的保护率。回顾性评估了在我们中心接受手术的 271 例腔 A 型乳腺癌患者。在未接受新辅助治疗且接受保乳手术的 2 个或更少前哨淋巴结（SLN）阳性的患者中，省略了腋窝淋巴结清扫术（OAD）。不符合这些标准的 SLN 阳性患者行腋窝淋巴结清扫术（ALND）（前哨/ADAS 后的腋窝清扫）。
虽然对 212 例（77.9%）患者进行了前哨淋巴结活检（SLNB），但对 58 例（21.3%）患者进行了 SLNB+腋窝清扫术（AD），对 1 例（0.8%）患者进行了直接腋窝清扫术。在 18 例（23.6%）阳性患者中应用了 OAD。尽管腔 A 型乳腺癌的临床表现较轻，但在其治疗中，ALND 的比例仍然很高。为避免腋窝清扫的并发症，应尽可能考虑对患者进行 NAC。还需要新的新辅助或其他治疗选择。
