Effect of Neoadjuvant Chemotherapy on Axillary Lymph Node Positivity and Numbers in Breast Cancer Cases

Uyan, Mikail; Koca, Bülent; Yürüker, Savaş; Özen, Nurten

doi:10.7314/apjcp.2016.17.3.1181

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…Studies have shown that NACT did convert mastectomy patients to candidates for BCS and reduced the number of dissected lymph nodes. 26,74 However, patient preference played an important role in surgical modality, 22,75 particularly in the elderly subgroups preferred not to undergo BCS. More educational efforts are needed to make patients aware of the BCS option.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the proportion of patients treated with NACT before RM (35.15%) and MRM (24.87%) was higher than BCS (22.02%), and patients with metastatic tumors (33.88%) most frequently receive NACT compared to other subgroups. Studies have shown that NACT did convert mastectomy patients to candidates for BCS and reduced the number of dissected lymph nodes . However, patient preference played an important role in surgical modality, particularly in the elderly subgroups preferred not to undergo BCS.…”

Section: Discussionmentioning

confidence: 99%

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Present and changing trends in surgical modalities and neoadjuvant chemotherapy administration for female breast cancer in Beijing, China: A 10‐year (2006–2015) retrospective hospitalization summary report‐based study

et al. 2018

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BackgroundThis study was conducted to describe present and changing trends in surgical modalities and neoadjuvant chemotherapy (NACT) in female breast cancer patients in China from 2006 to 2015.MethodsData of 44 299 female breast cancer patients from 15 tertiary hospitals in Beijing were extracted from hospitalization summary reports. Surgeries were categorized into five modalities: breast‐conserving surgery (BCS), simple mastectomy (SM), modified radical mastectomy (MRM), radical mastectomy (RM), and extensive radical mastectomy (ERM).ResultsIn total, 38 471 (86.84%) breast cancer patients underwent surgery: 22.64% BCS, 8.22% SM, 63.97% MRM, 4.24% RM, and 0.93% ERM. Older patients (> 60) underwent surgery more frequently than younger patients (< 60). The proportion of patients who underwent BCS was highest in the age ≥ 80 (39.24%) and < 40 (28.69%) subgroups and in patients with papillary carcinoma (35.48%), and lowest in the age 60‐ subgroup (18.17%) and in patients with Paget's disease (19.05%). SM was most frequently performed in patients with Paget's disease (29.00%), and MRM for ductal (64.99%), and lobular (63.78%) carcinomas. During the study period, the proportion of patients who underwent MRM dropped by 29.04%, SM and BCS increased from 15.78% and 30.83%, respectively, and NACT increased in all subgroups, particularly in patients with lymph node involvement (26.72%).ConclusionsSurgical modalities varied significantly by age and histologic group. The use of BCS and SM increased dramatically, while MRM declined significantly. The proportion of patients treated with NACT has increased significantly, especially in patients with lymph node involvement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Present and changing trends in surgical modalities and neoadjuvant chemotherapy administration for female breast cancer in Beijing, China: A 10‐year (2006–2015) retrospective hospitalization summary report‐based study

et al. 2018

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“…The number of dissected lymph nodes from patients with breast cancer having NAC may be less than in patients without NAC, which may not always be carried out with an adequate ALND. Uyan et al showed that median number of ALND with NAC was 16, while it was 20 without NAC and 16.3% of patients with NAC had<10 lymph nodes [ 7 ]. Insufficient lymph node dissection may result in inaccurate lymph node staging, and removing more lymph nodes makes for a more accurate determination of lymph node status [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, ALND remains an important surgical method for oncological safety. Another study reported that the number of removed lymph nodes after NAC decreased and 16.3% of patients with NAC had less than 10 lymph nodes [ 7 ]. Thus, the decrease in the number of removed lymph nodes can underestimate the nodal stage.…”

Section: Introductionmentioning

confidence: 99%

Is Pathologic Axillary Staging Valid If Lymph Nodes Are Less than 10 with Axillary Lymph Node Dissection after Neoadjuvant Chemotherapy?

Choi

Ryu

Lee

et al. 2022

JCM

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Introduction: The aim of this study was to evaluate the prognostic value of the number of lymph nodes removed in breast cancer patients who undergo axillary lymph node dissection (ALND) after neoadjuvant chemotherapy (NAC). Methods: We included patients who were diagnosed with invasive breast cancer and cytology with proven involved axillary node metastasis at diagnosis and treated with NAC followed by curative surgery at Samsung Medical Center between January 2007 and December 2015. The primary outcomes were disease-free survival (DFS) and overall survival (OS). Results: Among 772 patients with NAC and ALND, there were 285 ypN0, 258 ypN1, 135 ypN2, and 94 ypN3 cases. The median follow-up duration was 69.0 months. The group with less than 10 lymph nodes number (<10 nodes group) included 123 patients and the group with 10 or more lymph nodes number (≥10 nodes group) included 649 patients. There were no significant differences in DFS (p = 0.501) or OS (p = 0.883) between the two groups. In the ypN0 subgroup, the <10 nodes group had worse DFS than ≥10 nodes group (p = 0.024). In the ypN1 subgroup, there were no significant differences in DFS (p = 0.846) or OS (p = 0.774) between the two groups. In the ypN2 subgroup, the <10 nodes group had worse DFS (p = 0.025) and OS (p = 0.031) than ≥10 nodes group Conclusion: In ypN0 and ypN2 subgroups, breast cancer patients with less than 10 lymph nodes number in ALND after NAC might be considered for additional staging or closer surveillance when compared to patients with 10 or more than lymph node.

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Multidisciplinary considerations in the management of breast cancer patients receiving neoadjuvant chemotherapy

Nakhlis

Portnow²,

Gombos³

et al. 2022

Current Problems in Surgery

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Effect of Neoadjuvant Chemotherapy on Axillary Lymph Node Positivity and Numbers in Breast Cancer Cases

Cited by 3 publications

References 17 publications

Present and changing trends in surgical modalities and neoadjuvant chemotherapy administration for female breast cancer in Beijing, China: A 10‐year (2006–2015) retrospective hospitalization summary report‐based study

Present and changing trends in surgical modalities and neoadjuvant chemotherapy administration for female breast cancer in Beijing, China: A 10‐year (2006–2015) retrospective hospitalization summary report‐based study

Is Pathologic Axillary Staging Valid If Lymph Nodes Are Less than 10 with Axillary Lymph Node Dissection after Neoadjuvant Chemotherapy?

Multidisciplinary considerations in the management of breast cancer patients receiving neoadjuvant chemotherapy

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