Management of the axilla in postmenopausal patients with cN0 hormone receptor-positive/HER2-negative breast cancer treated with neoadjuvant endocrine therapy and its prognostic impact
Purpose To evaluate the differences in nodal positivity if the sentinel lymph node biopsy (SLNB) is performed before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and its impact on prognosis. Methods A retrospective cohort study was performed in a single center including 91...
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| Veröffentlicht in: | Breast cancer research and treatment 2023-06, Vol.199 (3), p.445-456 |
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| creator | Garcia-Tejedor, Amparo Falo, Catalina Fernandez-Gonzalez, Sergi Laplana, Maria Gil-Gil, Miguel Soler-Monso, Teresa Martinez-Perez, Evelyn Calvo, Iris Calpelo, Hugo Bajen, Maria-Teresa Benitez, Ana Ortega, Raul Petit, Anna Guma, Anna Campos, Miriam Stradella, Agostina Lopez-Ojeda, Ana Ponce, Jordi Pla, Maria J. Pernas, Sonia |
| description | Purpose
To evaluate the differences in nodal positivity if the sentinel lymph node biopsy (SLNB) is performed before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and its impact on prognosis.
Methods
A retrospective cohort study was performed in a single center including 91 postmenopausal cases with clinically node-negative and hormone receptor-positive/HER2-negative (HR + /HER2−) breast cancer, treated with NET and SLNB. SLNB was done pre-NET until 2014, and post-NET thereafter. Axillary lymph node dissection (ALND) was indicated only in SLNB macrometastasis, although in selected elderly patients, it was omitted. Kaplan–Meier survival curves were estimated in relation to the status of the axilla, and the differences assessed using the log-rank test.
Results
Between December 2006 and March 2022, SLNB was performed pre-NET in 14 cases and post-NET in 77. Both groups were similar in baseline tumor and patient characteristics. SLNB positivity was similar regardless of whether SLNB was performed before (5/14, 35.7%) or after NET (27/77, 37%), with 2/14 SLN macrometastases in the pre-NET cohort and 17/77 in the post-NET cohort. Only three patients (18.7%) with SLN macrometastasis had > 3 positive nodes following ALND. The 5-year overall survival and distant disease-free survival were 92.4% and 94.8%, respectively, with no significant differences according to SLNB status (p 0.5 and 0.8, respectively).
Conclusion
SLN positivity did not differ according to its timing (before or after NET). Therefore, NET has no effect on lymph node clearance. Furthermore, the prognosis is good regardless of the axillary involvement. Therefore, factors other than axillary involvement may affect the prognosis in these patients. |
| doi_str_mv | 10.1007/s10549-023-06926-y |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2800148246</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A748966522</galeid><sourcerecordid>A748966522</sourcerecordid><originalsourceid>FETCH-LOGICAL-c468t-5d77660f656a7e02a9bd372189328377b25f6fc47596ff84b820b63da4501af13</originalsourceid><addsrcrecordid>eNp9ksFu1DAURSMEokPhB1ggS0iITVrbSexkWVWFIhWQEKyjF-dlxqPEDrbTMl_G7_GGKZQihLywHJ97c_10s-y54CeCc30aBa_KJueyyLlqpMp3D7KVqHSRayn0w2zFhdK5qrk6yp7EuOWcN5o3j7OjQvOyELxeZd_fg4M1TugS8wNLG2TwzY4jMOvY7GOiGz_DEmFkMyRLXGQ3Nm2Y-cDZxofJO2QBDc7Jh5wUNtlrPL28-CRzh2vYn1gXEGJiBpzBwBKdEvYHG4ce-u1yDRQAXe9NsGRIOQLMOwauZ5b-OAe_dpTGGmanGUx6mj0aYIz47HY_zr68ufh8fplffXz77vzsKjelqlNe9VorxQdVKdDIJTRdX9B06qaQdaF1J6tBDabUVaOGoS67WvJOFT2UFRcwiOI4e33wpQRfF4ypnWw0SAOi4EtsZc25KGtZKkJf_oVu_RIcpSNKSFlLKZs7ag0jttYNPgUwe9P2TJd1o1QlJVEn_6Bo9ThZQyMfLH2_J3j1h2CDMKZN9OOSrHfxPigPoAk-xoBDOwc7Qdi1grf7WrWHWrVUq_ZnrdodiV7cPm3pJux_S371iIDiAES6cmsMd2__j-0PiWrZpg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2812282229</pqid></control><display><type>article</type><title>Management of the axilla in postmenopausal patients with cN0 hormone receptor-positive/HER2-negative breast cancer treated with neoadjuvant endocrine therapy and its prognostic impact</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Garcia-Tejedor, Amparo ; Falo, Catalina ; Fernandez-Gonzalez, Sergi ; Laplana, Maria ; Gil-Gil, Miguel ; Soler-Monso, Teresa ; Martinez-Perez, Evelyn ; Calvo, Iris ; Calpelo, Hugo ; Bajen, Maria-Teresa ; Benitez, Ana ; Ortega, Raul ; Petit, Anna ; Guma, Anna ; Campos, Miriam ; Stradella, Agostina ; Lopez-Ojeda, Ana ; Ponce, Jordi ; Pla, Maria J. ; Pernas, Sonia</creator><creatorcontrib>Garcia-Tejedor, Amparo ; Falo, Catalina ; Fernandez-Gonzalez, Sergi ; Laplana, Maria ; Gil-Gil, Miguel ; Soler-Monso, Teresa ; Martinez-Perez, Evelyn ; Calvo, Iris ; Calpelo, Hugo ; Bajen, Maria-Teresa ; Benitez, Ana ; Ortega, Raul ; Petit, Anna ; Guma, Anna ; Campos, Miriam ; Stradella, Agostina ; Lopez-Ojeda, Ana ; Ponce, Jordi ; Pla, Maria J. ; Pernas, Sonia</creatorcontrib><description>Purpose
To evaluate the differences in nodal positivity if the sentinel lymph node biopsy (SLNB) is performed before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and its impact on prognosis.
Methods
A retrospective cohort study was performed in a single center including 91 postmenopausal cases with clinically node-negative and hormone receptor-positive/HER2-negative (HR + /HER2−) breast cancer, treated with NET and SLNB. SLNB was done pre-NET until 2014, and post-NET thereafter. Axillary lymph node dissection (ALND) was indicated only in SLNB macrometastasis, although in selected elderly patients, it was omitted. Kaplan–Meier survival curves were estimated in relation to the status of the axilla, and the differences assessed using the log-rank test.
Results
Between December 2006 and March 2022, SLNB was performed pre-NET in 14 cases and post-NET in 77. Both groups were similar in baseline tumor and patient characteristics. SLNB positivity was similar regardless of whether SLNB was performed before (5/14, 35.7%) or after NET (27/77, 37%), with 2/14 SLN macrometastases in the pre-NET cohort and 17/77 in the post-NET cohort. Only three patients (18.7%) with SLN macrometastasis had > 3 positive nodes following ALND. The 5-year overall survival and distant disease-free survival were 92.4% and 94.8%, respectively, with no significant differences according to SLNB status (p 0.5 and 0.8, respectively).
Conclusion
SLN positivity did not differ according to its timing (before or after NET). Therefore, NET has no effect on lymph node clearance. Furthermore, the prognosis is good regardless of the axillary involvement. Therefore, factors other than axillary involvement may affect the prognosis in these patients.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-023-06926-y</identifier><identifier>PMID: 37043108</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adjuvant treatment ; Aged ; Axilla - pathology ; Biopsy ; Breast cancer ; Breast Neoplasms - pathology ; Breast Neoplasms - therapy ; Cancer ; Cancer patients ; Cancer research ; Care and treatment ; Clinical Trial ; Endocrine therapy ; ErbB-2 protein ; Female ; Hormones ; Humans ; Lymph Node Excision ; Lymph nodes ; Lymphatic system ; Medical prognosis ; Medicine ; Medicine & Public Health ; Neoadjuvant Therapy ; Oncology ; Post-menopause ; Postmenopausal women ; Postmenopause ; Prognosis ; Retrospective Studies ; Sentinel Lymph Node Biopsy ; Survival</subject><ispartof>Breast cancer research and treatment, 2023-06, Vol.199 (3), p.445-456</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>COPYRIGHT 2023 Springer</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c468t-5d77660f656a7e02a9bd372189328377b25f6fc47596ff84b820b63da4501af13</cites><orcidid>0000-0002-1485-5080 ; 0000-0003-3398-0570</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-023-06926-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-023-06926-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37043108$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garcia-Tejedor, Amparo</creatorcontrib><creatorcontrib>Falo, Catalina</creatorcontrib><creatorcontrib>Fernandez-Gonzalez, Sergi</creatorcontrib><creatorcontrib>Laplana, Maria</creatorcontrib><creatorcontrib>Gil-Gil, Miguel</creatorcontrib><creatorcontrib>Soler-Monso, Teresa</creatorcontrib><creatorcontrib>Martinez-Perez, Evelyn</creatorcontrib><creatorcontrib>Calvo, Iris</creatorcontrib><creatorcontrib>Calpelo, Hugo</creatorcontrib><creatorcontrib>Bajen, Maria-Teresa</creatorcontrib><creatorcontrib>Benitez, Ana</creatorcontrib><creatorcontrib>Ortega, Raul</creatorcontrib><creatorcontrib>Petit, Anna</creatorcontrib><creatorcontrib>Guma, Anna</creatorcontrib><creatorcontrib>Campos, Miriam</creatorcontrib><creatorcontrib>Stradella, Agostina</creatorcontrib><creatorcontrib>Lopez-Ojeda, Ana</creatorcontrib><creatorcontrib>Ponce, Jordi</creatorcontrib><creatorcontrib>Pla, Maria J.</creatorcontrib><creatorcontrib>Pernas, Sonia</creatorcontrib><title>Management of the axilla in postmenopausal patients with cN0 hormone receptor-positive/HER2-negative breast cancer treated with neoadjuvant endocrine therapy and its prognostic impact</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
To evaluate the differences in nodal positivity if the sentinel lymph node biopsy (SLNB) is performed before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and its impact on prognosis.
Methods
A retrospective cohort study was performed in a single center including 91 postmenopausal cases with clinically node-negative and hormone receptor-positive/HER2-negative (HR + /HER2−) breast cancer, treated with NET and SLNB. SLNB was done pre-NET until 2014, and post-NET thereafter. Axillary lymph node dissection (ALND) was indicated only in SLNB macrometastasis, although in selected elderly patients, it was omitted. Kaplan–Meier survival curves were estimated in relation to the status of the axilla, and the differences assessed using the log-rank test.
Results
Between December 2006 and March 2022, SLNB was performed pre-NET in 14 cases and post-NET in 77. Both groups were similar in baseline tumor and patient characteristics. SLNB positivity was similar regardless of whether SLNB was performed before (5/14, 35.7%) or after NET (27/77, 37%), with 2/14 SLN macrometastases in the pre-NET cohort and 17/77 in the post-NET cohort. Only three patients (18.7%) with SLN macrometastasis had > 3 positive nodes following ALND. The 5-year overall survival and distant disease-free survival were 92.4% and 94.8%, respectively, with no significant differences according to SLNB status (p 0.5 and 0.8, respectively).
Conclusion
SLN positivity did not differ according to its timing (before or after NET). Therefore, NET has no effect on lymph node clearance. Furthermore, the prognosis is good regardless of the axillary involvement. Therefore, factors other than axillary involvement may affect the prognosis in these patients.</description><subject>Adjuvant treatment</subject><subject>Aged</subject><subject>Axilla - pathology</subject><subject>Biopsy</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - therapy</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Care and treatment</subject><subject>Clinical Trial</subject><subject>Endocrine therapy</subject><subject>ErbB-2 protein</subject><subject>Female</subject><subject>Hormones</subject><subject>Humans</subject><subject>Lymph Node Excision</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoadjuvant Therapy</subject><subject>Oncology</subject><subject>Post-menopause</subject><subject>Postmenopausal women</subject><subject>Postmenopause</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Survival</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ksFu1DAURSMEokPhB1ggS0iITVrbSexkWVWFIhWQEKyjF-dlxqPEDrbTMl_G7_GGKZQihLywHJ97c_10s-y54CeCc30aBa_KJueyyLlqpMp3D7KVqHSRayn0w2zFhdK5qrk6yp7EuOWcN5o3j7OjQvOyELxeZd_fg4M1TugS8wNLG2TwzY4jMOvY7GOiGz_DEmFkMyRLXGQ3Nm2Y-cDZxofJO2QBDc7Jh5wUNtlrPL28-CRzh2vYn1gXEGJiBpzBwBKdEvYHG4ce-u1yDRQAXe9NsGRIOQLMOwauZ5b-OAe_dpTGGmanGUx6mj0aYIz47HY_zr68ufh8fplffXz77vzsKjelqlNe9VorxQdVKdDIJTRdX9B06qaQdaF1J6tBDabUVaOGoS67WvJOFT2UFRcwiOI4e33wpQRfF4ypnWw0SAOi4EtsZc25KGtZKkJf_oVu_RIcpSNKSFlLKZs7ag0jttYNPgUwe9P2TJd1o1QlJVEn_6Bo9ThZQyMfLH2_J3j1h2CDMKZN9OOSrHfxPigPoAk-xoBDOwc7Qdi1grf7WrWHWrVUq_ZnrdodiV7cPm3pJux_S371iIDiAES6cmsMd2__j-0PiWrZpg</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Garcia-Tejedor, Amparo</creator><creator>Falo, Catalina</creator><creator>Fernandez-Gonzalez, Sergi</creator><creator>Laplana, Maria</creator><creator>Gil-Gil, Miguel</creator><creator>Soler-Monso, Teresa</creator><creator>Martinez-Perez, Evelyn</creator><creator>Calvo, Iris</creator><creator>Calpelo, Hugo</creator><creator>Bajen, Maria-Teresa</creator><creator>Benitez, Ana</creator><creator>Ortega, Raul</creator><creator>Petit, Anna</creator><creator>Guma, Anna</creator><creator>Campos, Miriam</creator><creator>Stradella, Agostina</creator><creator>Lopez-Ojeda, Ana</creator><creator>Ponce, Jordi</creator><creator>Pla, Maria J.</creator><creator>Pernas, Sonia</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1485-5080</orcidid><orcidid>https://orcid.org/0000-0003-3398-0570</orcidid></search><sort><creationdate>20230601</creationdate><title>Management of the axilla in postmenopausal patients with cN0 hormone receptor-positive/HER2-negative breast cancer treated with neoadjuvant endocrine therapy and its prognostic impact</title><author>Garcia-Tejedor, Amparo ; Falo, Catalina ; Fernandez-Gonzalez, Sergi ; Laplana, Maria ; Gil-Gil, Miguel ; Soler-Monso, Teresa ; Martinez-Perez, Evelyn ; Calvo, Iris ; Calpelo, Hugo ; Bajen, Maria-Teresa ; Benitez, Ana ; Ortega, Raul ; Petit, Anna ; Guma, Anna ; Campos, Miriam ; Stradella, Agostina ; Lopez-Ojeda, Ana ; Ponce, Jordi ; Pla, Maria J. ; Pernas, Sonia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-5d77660f656a7e02a9bd372189328377b25f6fc47596ff84b820b63da4501af13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adjuvant treatment</topic><topic>Aged</topic><topic>Axilla - pathology</topic><topic>Biopsy</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - therapy</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Care and treatment</topic><topic>Clinical Trial</topic><topic>Endocrine therapy</topic><topic>ErbB-2 protein</topic><topic>Female</topic><topic>Hormones</topic><topic>Humans</topic><topic>Lymph Node Excision</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoadjuvant Therapy</topic><topic>Oncology</topic><topic>Post-menopause</topic><topic>Postmenopausal women</topic><topic>Postmenopause</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Garcia-Tejedor, Amparo</creatorcontrib><creatorcontrib>Falo, Catalina</creatorcontrib><creatorcontrib>Fernandez-Gonzalez, Sergi</creatorcontrib><creatorcontrib>Laplana, Maria</creatorcontrib><creatorcontrib>Gil-Gil, Miguel</creatorcontrib><creatorcontrib>Soler-Monso, Teresa</creatorcontrib><creatorcontrib>Martinez-Perez, Evelyn</creatorcontrib><creatorcontrib>Calvo, Iris</creatorcontrib><creatorcontrib>Calpelo, Hugo</creatorcontrib><creatorcontrib>Bajen, Maria-Teresa</creatorcontrib><creatorcontrib>Benitez, Ana</creatorcontrib><creatorcontrib>Ortega, Raul</creatorcontrib><creatorcontrib>Petit, Anna</creatorcontrib><creatorcontrib>Guma, Anna</creatorcontrib><creatorcontrib>Campos, Miriam</creatorcontrib><creatorcontrib>Stradella, Agostina</creatorcontrib><creatorcontrib>Lopez-Ojeda, Ana</creatorcontrib><creatorcontrib>Ponce, Jordi</creatorcontrib><creatorcontrib>Pla, Maria J.</creatorcontrib><creatorcontrib>Pernas, Sonia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Garcia-Tejedor, Amparo</au><au>Falo, Catalina</au><au>Fernandez-Gonzalez, Sergi</au><au>Laplana, Maria</au><au>Gil-Gil, Miguel</au><au>Soler-Monso, Teresa</au><au>Martinez-Perez, Evelyn</au><au>Calvo, Iris</au><au>Calpelo, Hugo</au><au>Bajen, Maria-Teresa</au><au>Benitez, Ana</au><au>Ortega, Raul</au><au>Petit, Anna</au><au>Guma, Anna</au><au>Campos, Miriam</au><au>Stradella, Agostina</au><au>Lopez-Ojeda, Ana</au><au>Ponce, Jordi</au><au>Pla, Maria J.</au><au>Pernas, Sonia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of the axilla in postmenopausal patients with cN0 hormone receptor-positive/HER2-negative breast cancer treated with neoadjuvant endocrine therapy and its prognostic impact</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>199</volume><issue>3</issue><spage>445</spage><epage>456</epage><pages>445-456</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Purpose
To evaluate the differences in nodal positivity if the sentinel lymph node biopsy (SLNB) is performed before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and its impact on prognosis.
Methods
A retrospective cohort study was performed in a single center including 91 postmenopausal cases with clinically node-negative and hormone receptor-positive/HER2-negative (HR + /HER2−) breast cancer, treated with NET and SLNB. SLNB was done pre-NET until 2014, and post-NET thereafter. Axillary lymph node dissection (ALND) was indicated only in SLNB macrometastasis, although in selected elderly patients, it was omitted. Kaplan–Meier survival curves were estimated in relation to the status of the axilla, and the differences assessed using the log-rank test.
Results
Between December 2006 and March 2022, SLNB was performed pre-NET in 14 cases and post-NET in 77. Both groups were similar in baseline tumor and patient characteristics. SLNB positivity was similar regardless of whether SLNB was performed before (5/14, 35.7%) or after NET (27/77, 37%), with 2/14 SLN macrometastases in the pre-NET cohort and 17/77 in the post-NET cohort. Only three patients (18.7%) with SLN macrometastasis had > 3 positive nodes following ALND. The 5-year overall survival and distant disease-free survival were 92.4% and 94.8%, respectively, with no significant differences according to SLNB status (p 0.5 and 0.8, respectively).
Conclusion
SLN positivity did not differ according to its timing (before or after NET). Therefore, NET has no effect on lymph node clearance. Furthermore, the prognosis is good regardless of the axillary involvement. Therefore, factors other than axillary involvement may affect the prognosis in these patients.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37043108</pmid><doi>10.1007/s10549-023-06926-y</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-1485-5080</orcidid><orcidid>https://orcid.org/0000-0003-3398-0570</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2023-06, Vol.199 (3), p.445-456 |
| issn | 0167-6806 1573-7217 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2800148246 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adjuvant treatment Aged Axilla - pathology Biopsy Breast cancer Breast Neoplasms - pathology Breast Neoplasms - therapy Cancer Cancer patients Cancer research Care and treatment Clinical Trial Endocrine therapy ErbB-2 protein Female Hormones Humans Lymph Node Excision Lymph nodes Lymphatic system Medical prognosis Medicine Medicine & Public Health Neoadjuvant Therapy Oncology Post-menopause Postmenopausal women Postmenopause Prognosis Retrospective Studies Sentinel Lymph Node Biopsy Survival |
| title | Management of the axilla in postmenopausal patients with cN0 hormone receptor-positive/HER2-negative breast cancer treated with neoadjuvant endocrine therapy and its prognostic impact |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T19%3A12%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Management%20of%20the%20axilla%20in%20postmenopausal%20patients%20with%20cN0%20hormone%20receptor-positive/HER2-negative%20breast%20cancer%20treated%20with%20neoadjuvant%20endocrine%20therapy%20and%20its%20prognostic%20impact&rft.jtitle=Breast%20cancer%20research%20and%20treatment&rft.au=Garcia-Tejedor,%20Amparo&rft.date=2023-06-01&rft.volume=199&rft.issue=3&rft.spage=445&rft.epage=456&rft.pages=445-456&rft.issn=0167-6806&rft.eissn=1573-7217&rft_id=info:doi/10.1007/s10549-023-06926-y&rft_dat=%3Cgale_proqu%3EA748966522%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2812282229&rft_id=info:pmid/37043108&rft_galeid=A748966522&rfr_iscdi=true |