Absence of post-treatment changes in sentinel lymph nodes does not translate into increased regional recurrence rate in initially node-positive breast cancer patients

Pišlar, Nina (author), Gašljević, Gorana (author), Ratoša, Ivica (author), Kovač, Anja (author), Žgajnar, Janez (author), Perhavec, Andraž (author)

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.

• Language: English
• 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
• Year: 2023
• Number of pages: Str. 443–450
• Numbering: Vol. 202, iss. 3
• PID: 20.500.12556/RUL-152576
• UDC: 618.1
• ISSN on article: 0167-6806
• DOI: 10.1007/s10549-023-07084-x
• COBISS.SI-ID: 164764163
• Publication date in RUL: 29.11.2023

Record is a part of a journal

• Title: Breast cancer research and treatment
• Shortened title: Breast cancer res. treat.
• Publisher: Springer Nature
• ISSN: 0167-6806
• COBISS.SI-ID: 25117952

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• 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

• Language: Slovenian
• Keywords: rak dojke, neoadjuvantno zdravljenje, posledice zdravljenja

Projects

• Funder: ARRS - Slovenian Research Agency
• Project number: P3-0352
• Name: Družine s povišano ali visoko ogroženostjo za raka: svetovanje, odkrivanje mutacij in preprečevanje raka