Absence of post-treatment changes in sentinel lymph nodes does not translate into increased regional recurrence rate in initially node-positive breast cancer patients
ID Pišlar, Nina (Author), ID Gašljević, Gorana (Author), ID Ratoša, Ivica (Author), ID Kovač, Anja (Author), ID Žgajnar, Janez (Author), ID Perhavec, Andraž (Author)

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Purpose To determine whether the absence of post-treatment changes in the negative sentinel lymph nodes (SLN) in the neoadjuvant setting for biopsy-proven cN + disease results in an increased regional recurrence (RR) rate in patients after SLN biopsy (SLNB) only. Methods Breast cancer patients with biopsy-proven cN + disease who converted to node-negative disease after neoadjuvant systemic treatment (NAST) and underwent SLNB only were included. Retrospective analysis was performed for patients diagnosed between 2008 and 2021. Pathohistological specimens were reviewed for the presence of post-treatment changes in the SLNs. Patients with negative SLNs (ypN0) were divided into two groups: (i) with post-treatment changes, (ii) without post-treatment changes. Patients' characteristics were compared between groups. Crude RR rates were compared using the log-rank test. Recurrence-free (RFS) and overall survival (OS) for the entire cohort were calculated using Kaplan–Meier. Results Of 437 patients with cN + disease, 95 underwent SLNB only. 82 were ypN0, 57 with post-treatment changes (group 1), 25 without post-treatment changes (group 2). During the median follow-up of 37 months (range 6–148), 1 isolated regional recurrence occurred in group 2 (RR rate 0% for group 1 vs. 4% for group 2, p = 0.149). There were no differences in 3-year RFS and OS between groups. Conclusion Absent post-treatment changes in negative SLNs for biopsy-proven cN + disease that covert to node-negative after NAST did not result in increased regional recurrence rates in our cohort. Multidisciplinary input is essential to determine whether additional treatment is needed in these patients.

Keywords:breast cancer, neoadjuvant, post-treatment changes, sentinel lymph node biopsy, regional recurrence
Work type:Article
Typology:1.01 - Original Scientific Article
Organization:MF - Faculty of Medicine
Publication status:Published
Publication version:Version of Record
Number of pages:Str. 443–450
Numbering:Vol. 202, iss. 3
PID:20.500.12556/RUL-152576 This link opens in a new window
ISSN on article:0167-6806
DOI:10.1007/s10549-023-07084-x This link opens in a new window
COBISS.SI-ID:164764163 This link opens in a new window
Publication date in RUL:29.11.2023
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Title:Breast cancer research and treatment
Shortened title:Breast cancer res. treat.
Publisher:Springer Nature
COBISS.SI-ID:25117952 This link opens in a new window


License:CC BY 4.0, Creative Commons Attribution 4.0 International
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

Keywords:rak dojke, neoadjuvantno zdravljenje, posledice zdravljenja


Funder:ARRS - Agencija za raziskovalno dejavnost Republike Slovenije
Project number:P3-0352
Name:Družine s povišano ali visoko ogroženostjo za raka: svetovanje, odkrivanje mutacij in preprečevanje raka

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