Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Cancer Med. 2024 Jan;13(1):e6868. doi: 10.1002/cam4.6868. Epub 2023 Dec 22.
BACKGROUND: The feasibility of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) in initially node-positive patients is still controversial. We aim to evaluate the oncologic outcomes of SLNB after NACT and further compare the results between those who were initially node-negative and node-positive. METHODS: This is a retrospective cohort that included patients diagnosed with invasive breast cancer and had surgical management between January 2010 and December 2016. Survival and recurrence data after 3-5 years were collected from patients' records. We divided patients into Group A who were initially node-negative and had SLNB ± axillary lymph node dissection (ALND) and Group B who were node-positive and had SLNB ± ALND. RESULTS: Among initially node-negative patients, 43 out of 63 patients did SLNB (Group A). However, among initially node-positive patients only 28 out of 123 patients did SLNB (Group B). Out of the 71 patients who did SLNB after NACT, 26 patients had positive SLNs with only 14 patients who further underwent ALND. The identification rate of SLNB was 100% in Group A and 96.4% in Group B. The survival curves by nodal status showed no significant difference between overall survival and recurrence-free survival at 5 years between patients in Group A versus Group. CONCLUSION: The results suggest that in properly selected patients, SLNB can be feasible after NACT. Our results resemble the reported literature on accuracy of SLNB after NACT and adds to the growing pool of data on this topic.
背景:新辅助化疗(NACT)后前哨淋巴结活检(SLNB)的可行性在最初淋巴结阳性的患者中仍存在争议。我们旨在评估 NACT 后 SLNB 的肿瘤学结果,并进一步比较最初淋巴结阴性和阳性患者的结果。
方法:这是一项回顾性队列研究,纳入了 2010 年 1 月至 2016 年 12 月期间接受手术治疗的浸润性乳腺癌患者。从患者的病历中收集了 3-5 年后的生存和复发数据。我们将患者分为 A 组(最初淋巴结阴性且行 SLNB±腋窝淋巴结清扫术(ALND))和 B 组(最初淋巴结阳性且行 SLNB±ALND)。
结果:在最初淋巴结阴性的患者中,63 例中有 43 例行 SLNB(A 组)。然而,在最初淋巴结阳性的患者中,123 例仅有 28 例行 SLNB(B 组)。在接受 NACT 后行 SLNB 的 71 例患者中,26 例 SLN 阳性,仅有 14 例进一步行 ALND。A 组的 SLNB 检出率为 100%,B 组为 96.4%。根据淋巴结状态绘制的生存曲线显示,A 组和 B 组患者的总生存和无复发生存率在 5 年时无显著差异。
结论:结果表明,在适当选择的患者中,NACT 后 SLNB 是可行的。我们的结果与 NACT 后 SLNB 的准确性报告文献相似,并为该主题的不断增加的数据做出了贡献。
J Surg Oncol. 2003-10