Surgery Medical News about Breast cancer; axillary microresiduals; neoadjuvant chemotherapy

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Clinical significance of axillary microresiduals after neoadjuvant chemotherapy in breast cancer patients with cytologically proven metastases
Annals of Surgical Oncology, 07/15/09

Sakakibara M et al. - In a trial to evaluate the clinical significance of residual micrometastases and explore screening methods after NAC in pts with cytologically proven axillary metastases, it appears that using multislice sectioning, screening for ALN-mic after neoadjuvant chemotherapy (NAC) was clinically important, and that for ALN-itc was not clinically essential.

Methods

80 pts with a diagnosis of cytologically-proven axillary metastases received NAC.
All dissected lymph nodes were evaluated using multislice sectioning and cytokeratin immunohistochemistry, and categorized into 4 groups: no metastases (ALN-pCR), and with metastases ≤0.2 mm (ALN-itc), >0.2 mm but ≤2 mm (ALN-mic), and >2 mm (ALN-mac).
Disease-free survival (DFS) and overall survival (OS) were calculated by Kaplan–Meier method based on status of residual metastases.

Results

DFS in pts with ALN-pCR and ALN-itc was significantly longer than that with ALN-mic.
OS with ALN-pCR was significantly longer than that with ALN-mic.
There was no significant difference in DFS or OS between ALN-mac and ALN-mic.
These data showed the clinical significance of microresidual metastases >0.2 mm after NAC in pts with cytologically proven axillary metastases.

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