Axillary dissection for low-volume nodal involvement after neoadjuvant therapy in breast cancer: multicentre AXSANA cohort study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F25%3A10503593" target="_blank" >RIV/00064165:_____/25:10503593 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/25:10503593

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=wysj87R5oo" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=wysj87R5oo</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/bjs/znaf180" target="_blank" >10.1093/bjs/znaf180</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Axillary dissection for low-volume nodal involvement after neoadjuvant therapy in breast cancer: multicentre AXSANA cohort study

Popis výsledku v původním jazyce

Background: Completion axillary lymph node dissection (cALND) is often recommended for patients with isolated tumour cells (ITCs) or micrometastases in the sentinel lymph node (SLN) or target lymph node (TLN) to assess the definite nodal tumour burden after neoadjuvant chemotherapy (NACT). The aim of this study was to investigate the upgrade of N stage by cALND in patients with low-volume metastases in the SLN/TLN after NACT from the prospective, international, multicentre AXSANA cohort study. Methods: NACT-treated patients that converted from a positive to a negative clinical lymph node status and underwent cALND based on low-volume SLN/TLN involvement were included. The association between the final N stage, the pathological tumour response in the breast, and the clinical impact of cALND on post-NACT treatment decisions was determined. Results: Among 5329 patients recruited between June 2020 and March 2024, 2194 were scheduled for SLN biopsy (SLNB), targeted axillary dissection (TAD), or TLN biopsy (TLNB). Among 16 patients with ypN0i+(SLN/TLN), one patient was upgraded to ypN1a by cALND, while five of the 71 patients with ypN1mi(SLN/TLN) were upstaged to ypN2 and one of the 71 patients with ypN1mi(SLN/TLN) was upstaged to ypN3. None of these patients had a pCR in the breast and thus nodal upstaging had no impact on post-NACT treatment decisions. Conclusion: Despite substantial additional nodal involvement in low-volume SLN/TLN disease, cALND does not provide clinically meaningful information for post-NACT systemic treatment modifications and should not be encouraged for diagnostic purposes alone.

Název v anglickém jazyce

Axillary dissection for low-volume nodal involvement after neoadjuvant therapy in breast cancer: multicentre AXSANA cohort study

Popis výsledku anglicky

Background: Completion axillary lymph node dissection (cALND) is often recommended for patients with isolated tumour cells (ITCs) or micrometastases in the sentinel lymph node (SLN) or target lymph node (TLN) to assess the definite nodal tumour burden after neoadjuvant chemotherapy (NACT). The aim of this study was to investigate the upgrade of N stage by cALND in patients with low-volume metastases in the SLN/TLN after NACT from the prospective, international, multicentre AXSANA cohort study. Methods: NACT-treated patients that converted from a positive to a negative clinical lymph node status and underwent cALND based on low-volume SLN/TLN involvement were included. The association between the final N stage, the pathological tumour response in the breast, and the clinical impact of cALND on post-NACT treatment decisions was determined. Results: Among 5329 patients recruited between June 2020 and March 2024, 2194 were scheduled for SLN biopsy (SLNB), targeted axillary dissection (TAD), or TLN biopsy (TLNB). Among 16 patients with ypN0i+(SLN/TLN), one patient was upgraded to ypN1a by cALND, while five of the 71 patients with ypN1mi(SLN/TLN) were upstaged to ypN2 and one of the 71 patients with ypN1mi(SLN/TLN) was upstaged to ypN3. None of these patients had a pCR in the breast and thus nodal upstaging had no impact on post-NACT treatment decisions. Conclusion: Despite substantial additional nodal involvement in low-volume SLN/TLN disease, cALND does not provide clinically meaningful information for post-NACT systemic treatment modifications and should not be encouraged for diagnostic purposes alone.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30214 - Obstetrics and gynaecology

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

British Journal of Surgery

ISSN

0007-1323

e-ISSN

1365-2168

Svazek periodika

112

Číslo periodika v rámci svazku

9

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

12

Strana od-do

znaf180

Kód UT WoS článku

001574594500001

EID výsledku v databázi Scopus

2-s2.0-105016707832