Axillary-conserving surgery is facilitated by neoadjuvant chemotherapy of breast cancer
Beatty AD et al. - In a trial to examine the downstaging of breast cancer axillary lymph node (ALN) metastasis by neoadjuvant chemotherapy (NCT) and potential facilitation of axillary-conserving surgery, it was shown that NCT downstages primary breast cancer and ALN metastasis. ALN and SLN biopsy following, rather than before, NCT facilitate both breast- and axillary-conserving surgery. Methods- Records of breast cancer pts treated with NCT, breast surgery, and pathological ALN assessment were reviewed using the institutional breast cancer database.
Results- Of 473 cases, 309 (65%) were clinically ALN-positive (cN+) and 164 (35%) were clinically ALN-negative (cN-).
- Pre-NCT, needle biopsy, sentinel lymph node (SLN) biopsy, or axillary dissection documented metastasis in 94% (117/124) of cN+ and 27% (13/49) of cN- pts tested.
- Pathological complete response of ALNs to NCT was documented in 36% (41/115) of pts.
- False negative SLN biopsy following NCT occurred in 4% of cases (1/28).
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