Consenso de la Sociedad Española de Senología y Patología Mamaria (SESPM) sobre la biopsia selectiva del ganglio centinela (BSGC) y el manejo axilar en el cáncer de mama (2022)

Bernet, Laia; Piñero, Antonio; Martínez, María Labalde; Vidal-Sicart, Sergi; Algara, Manel; Palomares, Eugeni

doi:10.1016/j.senol.2022.07.002

Cited by 3 publications

(1 citation statement)

References 83 publications

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“…SLNB is a post- NST staging procedure for cN0 patients (I, A). In those with a clinically positive axillary node (cN1) who achieve a complete clinical response after NST, axillary dissection can be avoided if ≥ 3 sentinel nodes are identified and all are negative, or when the marked involved node(s) at diagnoses is/are removed, in addition to the sentinel node, and all of them are free of tumor cells [ 34 ]. Any residual nodal disease after NST on sentinel node biopsy usually warrant ALND (RT trials are on-going).…”

Section: Local–regional Therapymentioning

confidence: 99%

SEOM-GEICAM-SOLTI clinical guidelines for early-stage breast cancer (2022)

et al. 2023

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Breast cancer is the leading cause of cancer in women in Spain and its annual incidence is rapidly increasing. Thanks to the screening programs in place, nearly 90% of breast cancer cases are detected in early and potentially curable stages, despite the COVID-19 pandemic possibly having impacted these numbers (not yet quantified). In recent years, locoregional and systemic therapies are increasingly being directed by new diagnostic tools that have improved the balance between toxicity and clinical benefit. New therapeutic strategies, such as immunotherapy, targeted drugs, and antibody–drug conjugates have also improved outcomes in some patient subgroups. This clinical practice guideline is based on a systematic review of relevant studies and on the consensus of experts from GEICAM, SOLTI, and SEOM.

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Section: Local–regional Therapymentioning

confidence: 99%

SEOM-GEICAM-SOLTI clinical guidelines for early-stage breast cancer (2022)

et al. 2023

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Validation of prognostic and predictive value of total tumoral load after primary systemic therapy in breast cancer using OSNA assay

Bernet-Vegué,

Cantero-González,

Sancho de Salas

et al. 2023

Clin Transl Oncol

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Purpose This study aimed to validate the classification of breast cancer (BC) patients in progression risk groups based on total tumor load (TTL) value to predict lymph node (LN) affectation after neo-adjuvant systemic therapy (NAST) obtained in the NEOVATTL study. Methods/patients This was an observational, retrospective, international, multicenter study including patients with infiltrating BC who received NAST followed by sentinel lymph node biopsy (SLNB) analyzed with one-step nucleic acid amplification (OSNA) from nine Spanish and two Italian hospitals. Patients were classified into three groups according to the progression risk, measured as disease-free survival (DFS), based on TTL values (> 250, 250–25,000, and > 25,000 copies/μL). The previous (NEOVATTL study) Cox regression model for prognosis was validated using prognostic index (PI) and Log ratio test (LRT) analyses; the value of TTL for axillary non-SLN affectation was assessed using receiver operating characteristic (ROC) curves. Results We included 263 patients with a mean age of 51.4 (± SD 10.5) years. Patients with TTL > 25,000 copies/μL had a shorter DFS (HR 3.561 [95% CI 1.693−7.489], p = 0.0008 vs. TTL ≤ 25,000). PI and LRT analyses showed no differences between the two cohorts (p = 0.2553 and p = 0.226, respectively). ROC analysis showed concordance between TTL and non-SLN involvement (area under the curve 0.828), with 95.7% sensitivity and 92.9% specificity at a TTL cut-off of > 15,000 copies/μL. Conclusions In BC patients who had received NAST and underwent SLNB analysis using OSNA, a TTL value of > 25,000 copies/μL was associated with a higher progression risk and > 15,000 copies/μL was predictive of non-SLN involvement.

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