The Clinical Relevance of Target Lymph Node Biopsy after Primary Systemic Therapy in Initially Node-Positive Breast Cancer Patients
Purpose: To assess the impact of the removal of the target lymph node (TLN) on therapy after the completion of primary systemic therapy (PST) in initially node-positive breast cancer patients. Methods: Pooled data analysis of participants of the prospective CLIP- and TATTOO-study at the University o...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/11/2620 |
| _version_ | 1797532560676356096 |
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| author | Steffi Hartmann Angrit Stachs Gesche Schultek Bernd Gerber Toralf Reimer |
| author_facet | Steffi Hartmann Angrit Stachs Gesche Schultek Bernd Gerber Toralf Reimer |
| author_sort | Steffi Hartmann |
| collection | DOAJ |
| description | Purpose: To assess the impact of the removal of the target lymph node (TLN) on therapy after the completion of primary systemic therapy (PST) in initially node-positive breast cancer patients. Methods: Pooled data analysis of participants of the prospective CLIP- and TATTOO-study at the University of Rostock was performed. Results: A total of 75 patients were included; 63 of them (84.0%) converted to clinically node-negative after PST. Both TLN and sentinel lymph node (SLN) were identified in 41 patients (51.2%). In five out of 63 patients (7.9%), the TLN was metastatic after PST and the SLN was either tumor-free or not detected. Axillary lymph node dissection (ALND) was conducted in all five patients. In one patient, systemic therapy recommendation was influenced by the TLN; adjuvant radiotherapy was influenced by the TLN in zero patients. For patients with fewer than three removed SLNs, the FNR was 28.6% for the SLN biopsy alone and 7.1% for targeted axillary dissection (TAD). Conclusions: Removal of the TLN in addition to the SLN after PST has only minimal impact on the type of adjuvant systemic therapy and radiotherapy. However, the extent of axillary surgery was relevantly affected and FNR was improved by TAD. |
| first_indexed | 2024-03-10T11:01:57Z |
| format | Article |
| id | doaj.art-e9908e249b59425bb8f73fbaf308212c |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T11:01:57Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e9908e249b59425bb8f73fbaf308212c2023-11-21T21:30:41ZengMDPI AGCancers2072-66942021-05-011311262010.3390/cancers13112620The Clinical Relevance of Target Lymph Node Biopsy after Primary Systemic Therapy in Initially Node-Positive Breast Cancer PatientsSteffi Hartmann0Angrit Stachs1Gesche Schultek2Bernd Gerber3Toralf Reimer4Department of Obstetrics and Gynecology, University of Rostock, 18059 Rostock, GermanyDepartment of Obstetrics and Gynecology, University of Rostock, 18059 Rostock, GermanyDepartment of Obstetrics and Gynecology, University of Rostock, 18059 Rostock, GermanyDepartment of Obstetrics and Gynecology, University of Rostock, 18059 Rostock, GermanyDepartment of Obstetrics and Gynecology, University of Rostock, 18059 Rostock, GermanyPurpose: To assess the impact of the removal of the target lymph node (TLN) on therapy after the completion of primary systemic therapy (PST) in initially node-positive breast cancer patients. Methods: Pooled data analysis of participants of the prospective CLIP- and TATTOO-study at the University of Rostock was performed. Results: A total of 75 patients were included; 63 of them (84.0%) converted to clinically node-negative after PST. Both TLN and sentinel lymph node (SLN) were identified in 41 patients (51.2%). In five out of 63 patients (7.9%), the TLN was metastatic after PST and the SLN was either tumor-free or not detected. Axillary lymph node dissection (ALND) was conducted in all five patients. In one patient, systemic therapy recommendation was influenced by the TLN; adjuvant radiotherapy was influenced by the TLN in zero patients. For patients with fewer than three removed SLNs, the FNR was 28.6% for the SLN biopsy alone and 7.1% for targeted axillary dissection (TAD). Conclusions: Removal of the TLN in addition to the SLN after PST has only minimal impact on the type of adjuvant systemic therapy and radiotherapy. However, the extent of axillary surgery was relevantly affected and FNR was improved by TAD.https://www.mdpi.com/2072-6694/13/11/2620breast cancertarget lymph nodeprimary systemic therapysentinel lymph nodetargeted axillary dissection |
| spellingShingle | Steffi Hartmann Angrit Stachs Gesche Schultek Bernd Gerber Toralf Reimer The Clinical Relevance of Target Lymph Node Biopsy after Primary Systemic Therapy in Initially Node-Positive Breast Cancer Patients Cancers breast cancer target lymph node primary systemic therapy sentinel lymph node targeted axillary dissection |
| title | The Clinical Relevance of Target Lymph Node Biopsy after Primary Systemic Therapy in Initially Node-Positive Breast Cancer Patients |
| title_full | The Clinical Relevance of Target Lymph Node Biopsy after Primary Systemic Therapy in Initially Node-Positive Breast Cancer Patients |
| title_fullStr | The Clinical Relevance of Target Lymph Node Biopsy after Primary Systemic Therapy in Initially Node-Positive Breast Cancer Patients |
| title_full_unstemmed | The Clinical Relevance of Target Lymph Node Biopsy after Primary Systemic Therapy in Initially Node-Positive Breast Cancer Patients |
| title_short | The Clinical Relevance of Target Lymph Node Biopsy after Primary Systemic Therapy in Initially Node-Positive Breast Cancer Patients |
| title_sort | clinical relevance of target lymph node biopsy after primary systemic therapy in initially node positive breast cancer patients |
| topic | breast cancer target lymph node primary systemic therapy sentinel lymph node targeted axillary dissection |
| url | https://www.mdpi.com/2072-6694/13/11/2620 |
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