Higher Pathological Complete Response Rate of Less than 10 Total Axillary Lymph Nodes After Axillary Lymph Node Dissection Following Neoadjuvant Chemotherapy in Breast Cancer
BackgroundThe American Joint Committee on Cancer (AJCC) guideline recommends the evaluation of ≥10 axillary lymph nodes (ALN) in patients with breast cancer to assess the N stage. However, the total ALN count in ALN dissection (ALND) often decreases after neoadjuvant chemotherapy in breast cancer. T...
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.678169/full |
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| author | Jeeyeon Lee Jeeyeon Lee Nora Jee-Young Park Nora Jee-Young Park Byeongju Kang Byeongju Kang Jin Hyang Jung Jin Hyang Jung Wan Wook Kim Wan Wook Kim Yee Soo Chae Yee Soo Chae Soo Jung Lee Soo Jung Lee Hye Jung Kim Hye Jung Kim Ji-Young Park Ji-Young Park Ho Yong Park Ho Yong Park |
| author_facet | Jeeyeon Lee Jeeyeon Lee Nora Jee-Young Park Nora Jee-Young Park Byeongju Kang Byeongju Kang Jin Hyang Jung Jin Hyang Jung Wan Wook Kim Wan Wook Kim Yee Soo Chae Yee Soo Chae Soo Jung Lee Soo Jung Lee Hye Jung Kim Hye Jung Kim Ji-Young Park Ji-Young Park Ho Yong Park Ho Yong Park |
| author_sort | Jeeyeon Lee |
| collection | DOAJ |
| description | BackgroundThe American Joint Committee on Cancer (AJCC) guideline recommends the evaluation of ≥10 axillary lymph nodes (ALN) in patients with breast cancer to assess the N stage. However, the total ALN count in ALN dissection (ALND) often decreases after neoadjuvant chemotherapy in breast cancer. The authors compared clinicopathological factors and oncological outcomes between <10 vs. ≥10 ALNs after ALND following neoadjuvant chemotherapy in breast cancer.MethodsData of 159 patients with breast cancer, treated with neoadjuvant chemotherapy and ALND, were reviewed, and the cases were classified into two groups (<10 vs. ≥10 ALN count). The treatment response was determined based on the RECIST 1.1 criteria, and histopathological regression of the tumor was assessed based on the Miller-Payne grading scales.ResultsMost of the clinical and pathological factors did not demonstrate any significant differences between the two groups. However, the pathological complete response (pCR) rate in breast lesion and ALNs were the higher trend in the group with <10 ALNs. During the 88-month follow-up period, there was no significant difference in locoregional recurrence, distant metastasis, or overall survival.ConclusionsAlthough there was a limitation due to different sample sizes, additional axillary surgery may not be necessary even in cases with <10 total ALNs after ALND, following neoadjuvant chemotherapy because the lymph nodes are more likely to have been regressed themselves due to neoadjuvant chemotherapy, and the residual lymph nodes may be absent. |
| first_indexed | 2024-12-13T01:38:29Z |
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| id | doaj.art-df64e401f0eb4caa98a0ee3da2ca4ee2 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-13T01:38:29Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-df64e401f0eb4caa98a0ee3da2ca4ee22022-12-22T00:03:51ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-03-01910.3389/fsurg.2022.678169678169Higher Pathological Complete Response Rate of Less than 10 Total Axillary Lymph Nodes After Axillary Lymph Node Dissection Following Neoadjuvant Chemotherapy in Breast CancerJeeyeon Lee0Jeeyeon Lee1Nora Jee-Young Park2Nora Jee-Young Park3Byeongju Kang4Byeongju Kang5Jin Hyang Jung6Jin Hyang Jung7Wan Wook Kim8Wan Wook Kim9Yee Soo Chae10Yee Soo Chae11Soo Jung Lee12Soo Jung Lee13Hye Jung Kim14Hye Jung Kim15Ji-Young Park16Ji-Young Park17Ho Yong Park18Ho Yong Park19Department of Surgery, School of Medicine, Kyungpook National University, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Pathology, School of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Oncology/Hematology, School of Medicine, Kyungpook National University, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Oncology/Hematology, School of Medicine, Kyungpook National University, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Radiology, School of Medicine, Kyungpook National University, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Pathology, School of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu, South KoreaKyungpook National University Chilgok Hospital, Daegu, South KoreaBackgroundThe American Joint Committee on Cancer (AJCC) guideline recommends the evaluation of ≥10 axillary lymph nodes (ALN) in patients with breast cancer to assess the N stage. However, the total ALN count in ALN dissection (ALND) often decreases after neoadjuvant chemotherapy in breast cancer. The authors compared clinicopathological factors and oncological outcomes between <10 vs. ≥10 ALNs after ALND following neoadjuvant chemotherapy in breast cancer.MethodsData of 159 patients with breast cancer, treated with neoadjuvant chemotherapy and ALND, were reviewed, and the cases were classified into two groups (<10 vs. ≥10 ALN count). The treatment response was determined based on the RECIST 1.1 criteria, and histopathological regression of the tumor was assessed based on the Miller-Payne grading scales.ResultsMost of the clinical and pathological factors did not demonstrate any significant differences between the two groups. However, the pathological complete response (pCR) rate in breast lesion and ALNs were the higher trend in the group with <10 ALNs. During the 88-month follow-up period, there was no significant difference in locoregional recurrence, distant metastasis, or overall survival.ConclusionsAlthough there was a limitation due to different sample sizes, additional axillary surgery may not be necessary even in cases with <10 total ALNs after ALND, following neoadjuvant chemotherapy because the lymph nodes are more likely to have been regressed themselves due to neoadjuvant chemotherapy, and the residual lymph nodes may be absent.https://www.frontiersin.org/articles/10.3389/fsurg.2022.678169/fullbreast canceraxillary lymph nodeneoadjuvant chemotherapypathological complete responsedissection |
| spellingShingle | Jeeyeon Lee Jeeyeon Lee Nora Jee-Young Park Nora Jee-Young Park Byeongju Kang Byeongju Kang Jin Hyang Jung Jin Hyang Jung Wan Wook Kim Wan Wook Kim Yee Soo Chae Yee Soo Chae Soo Jung Lee Soo Jung Lee Hye Jung Kim Hye Jung Kim Ji-Young Park Ji-Young Park Ho Yong Park Ho Yong Park Higher Pathological Complete Response Rate of Less than 10 Total Axillary Lymph Nodes After Axillary Lymph Node Dissection Following Neoadjuvant Chemotherapy in Breast Cancer Frontiers in Surgery breast cancer axillary lymph node neoadjuvant chemotherapy pathological complete response dissection |
| title | Higher Pathological Complete Response Rate of Less than 10 Total Axillary Lymph Nodes After Axillary Lymph Node Dissection Following Neoadjuvant Chemotherapy in Breast Cancer |
| title_full | Higher Pathological Complete Response Rate of Less than 10 Total Axillary Lymph Nodes After Axillary Lymph Node Dissection Following Neoadjuvant Chemotherapy in Breast Cancer |
| title_fullStr | Higher Pathological Complete Response Rate of Less than 10 Total Axillary Lymph Nodes After Axillary Lymph Node Dissection Following Neoadjuvant Chemotherapy in Breast Cancer |
| title_full_unstemmed | Higher Pathological Complete Response Rate of Less than 10 Total Axillary Lymph Nodes After Axillary Lymph Node Dissection Following Neoadjuvant Chemotherapy in Breast Cancer |
| title_short | Higher Pathological Complete Response Rate of Less than 10 Total Axillary Lymph Nodes After Axillary Lymph Node Dissection Following Neoadjuvant Chemotherapy in Breast Cancer |
| title_sort | higher pathological complete response rate of less than 10 total axillary lymph nodes after axillary lymph node dissection following neoadjuvant chemotherapy in breast cancer |
| topic | breast cancer axillary lymph node neoadjuvant chemotherapy pathological complete response dissection |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.678169/full |
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