Article
Oncology
Sue Zann Lim, Tae-Kyung Yoo, Sae Byul Lee, Jisun Kim, Il Yong Chung, Beom Seok Ko, Jong Won Lee, Byung Ho Son, Sei-Hyun Ahn, Seonok Kim, Hee Jeong Kim
Summary: This study suggests that patients who had complete disappearance of lymph nodes following neoadjuvant chemotherapy can be safely treated with SLNB alone, and have better survival rates compared to those who underwent ALND.
BREAST CANCER RESEARCH AND TREATMENT
(2023)
Article
Oncology
N. Cabioglu, H. Karanlik, N. Yildirim, M. Muslumanoglu, G. Cakmak Karadeniz, D. Trabulus Can, M. Tukenmez, Y. E. Ersoy, C. Uras, B. Zengel, S. Emiroglu, A. K. Polat, L. Yeniay, E. Ozkurt, H. Kara, K. Ibis, A. Aydiner, V Ozmen, A. Igci
Summary: This study evaluated factors affecting local outcome in cN+ breast cancer patients who underwent sentinel lymph node biopsy alone after neoadjuvant chemotherapy. The results suggest that axillary lymph node dissection may be avoided in selected cN+ patients who achieve breast and/or nodal pathological complete response, have low volume residual nodal disease with luminal characteristics, and receive axillary radiotherapy.
Article
Multidisciplinary Sciences
Jung Whan Chun, Jisun Kim, Il Yong Chung, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Sei-Hyun Ahn, Sae Byul Lee
Summary: This study analyzed the long-term outcomes of patients with residual N1 nodal disease following neoadjuvant chemotherapy for breast cancer and found that omission of axillary lymph node dissection using propensity score matching was oncologically safe. No significant differences in axillary recurrence-free survival, distant metastasis-free survival, overall survival, and breast cancer-free survival were observed between SLNB only group and ALND group after propensity score matching.
SCIENTIFIC REPORTS
(2021)
Article
Oncology
Minyan Chen, Shengmei Li, Meng Huang, Jingjing Guo, Xuan Huang, Wenhui Guo, Lili Chen, Yuxiang Lin, Lisa Jacobs, Chuan Wang, Fangmeng Fu
Summary: This study evaluated the feasibility and accuracy of using methylene-blue-dye alone for sentinel lymph node biopsy (SLNB) in node-positive breast cancer. The results showed that using a flowchart to optimize patient selection significantly reduces the false-negative rate (FNR).
BREAST CANCER RESEARCH AND TREATMENT
(2022)
Article
Oncology
Giacomo Montagna, Minna K. Lee, Varadan Sevilimedu, Andrea Barrio, Monica Morrow
Summary: In cN1 patients rendered cN0 with neoadjuvant chemotherapy, when >= 3 sentinel lymph nodes (SLNs) are removed, the clipped node is an SLN in the majority of cases. Failure to retrieve the clipped node should not be an indication for axillary lymph node dissection (ALND).
ANNALS OF SURGICAL ONCOLOGY
(2022)
Editorial Material
Surgery
Abigail Suzanne Caudle
Summary: The surgical management of node-positive breast cancer after neoadjuvant chemotherapy is a focus and debate. The standard approach is axillary lymph node dissection, which carries risks of complications. Finding an accurate way to assess nodal response and defining the impact of minimizing axillary surgery on outcomes are the challenges. Ongoing trials may provide insights in the future.
Article
Oncology
Sabrina Kahler-Ribeiro-Fontana, Eleonora Pagan, Francesca Magnoni, Elisa Vicini, Consuelo Morigi, Giovanni Corso, Mattia Intra, Fiorella Canegallo, Silvia Ratini, Maria Cristina Leonardi, Eliana La Rocca, Vincenzo Bagnardi, Emilia Montagna, Marco Colleoni, Giuseppe Viale, Luca Bottiglieri, Chiara Maria Grana, Jorge Villanova Biasuz, Paolo Veronesi, Viviana Galimberti
Summary: This study evaluated the outcomes of patients undergoing NAT who remained or converted to cN0 and received SNB, showing a high overall survival rate after 10-year follow-up. The use of standard SNB in cN1/2 patients who become cN0 after NAT was deemed acceptable and did not result in worse outcomes.
Article
Oncology
Stacy B. Sanders, Tanya L. Hoskin, Arielle P. Stafford, Judy C. Boughey
Summary: This study evaluated the rate of non-sentinel lymph node (NSLN) positivity and factors influencing this in patients with a positive sentinel lymph node (SLN) following neoadjuvant chemotherapy (NAC). The results showed a high rate of nodal positivity on completion axillary lymph node dissection (cALND) in the setting of positive SLN after NAC, supporting the current standard of routine cALND. In patients with cN+ disease, NSLN positivity varied based on tumor biology, multicentricity/multifocality, number of positive SLNs, and SLN metastasis size.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Article
Multidisciplinary Sciences
Sae Byul Lee, Hakyoung Kim, Jisun Kim, Il Yong Chung, Hee Jeong Kim, Beom Seok Ko, Jong Won Lee, Sei Hyun Ahn, Byung Ho Son
Summary: This study found that performing only SLNB in breast cancer patients with cN positive pathology before neoadjuvant therapy but cN negative pathology after SLNB was associated with lower locoregional recurrence rates. There were significant differences in axillary recurrence and survival rates based on clinical and pathological lymph node status.
Article
Oncology
Gilles Houvenaeghel, Monique Cohen, Pedro Raro, Jeremy De Troyer, Pierre Gimbergues, Christine Tunon de Lara, Vivien Ceccato, Veronique Vaini-Cowen, Christelle Faure-Virelizier, Frederic Marchal, Tristan Gauthier, Eva Jouve, Pierrick Theret, Claudia Regis, Philippe Gabelle, Julia Pernaut, Francesco Del Piano, Gauthier D'Halluin, Stephane Lantheaume, Emile Darai, Bassoodeo Beedassy, Caroline Dhainaut-Speyer, Xavier Martin, Sophie Girard, Richard Villet, Emilie Monrigal, Theophile Hoyek, Jean-Francois Le Brun, Pierre-Emmanuel Colombo, Agnes Tallet, Jean-Marie Boher
Summary: The study analyzed the treatment and pathological results of patients included in the SERC trial, a multicenter randomized non-inferiority phase-3 trial comparing completion axillary lymph node dissection (cALND) with sentinel lymph node biopsy alone in breast cancer patients. Patients with one or two involved sentinel nodes by micro- or macro-metastases may not require cALND, but further research is needed for those with more than two involved nodes.
Article
Oncology
Viviana Galimberti, Sabrina Kahler Ribeiro Fontana, Elisa Vicini, Consuelo Morigi, Manuela Sargenti, Giovanni Corso, Francesca Magnoni, Mattia Intra, Paolo Veronesi
Summary: The increased use of neoadjuvant chemotherapy has changed the approach to breast surgery by allowing de-escalation of surgery and reducing axillary surgery. In addition, the response to neoadjuvant chemotherapy can affect the false negative rate of sentinel node biopsy. However, efforts to reduce this rate have shown to have no clinical prognostic significance. Studies have confirmed that using sentinel node surgery alone for patients with excellent response to neoadjuvant chemotherapy is rational and not inferior in terms of oncological outcomes.
Article
Oncology
Eun-Gyeong Lee, Minjung Lee, So-Youn Jung, Jai Hong Han, Seok-Ki Kim, Seeyoun Lee
Summary: A survey among breast surgeons of the Korean Breast Cancer Society showed that 67.7% of respondents would perform only SLN biopsy in the absence of SLN metastasis. The study also revealed an increasing trend towards adopting SLN biopsy for axillary staging in patients achieving complete response with initial nodal metastasis after NAC, with various mapping methods being utilized.
FRONTIERS IN ONCOLOGY
(2023)
Article
Medical Laboratory Technology
Rebecca Czaja, Ruizhe Wu, Julie M. Jorns
Summary: In recent years, there has been a trend towards less aggressive surgical management of axillary lymph nodes in breast cancer. This study evaluated the effectiveness of evaluating axillary sentinel lymph nodes and found that serial sectioning at 2-mm intervals reduced false negatives due to macrometastatic disease. Discordant cases were mostly false negatives detected on the first permanent section level due to sampling errors.
ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE
(2021)
Article
Oncology
Stephanie M. Wong, Mark Basik, Livia Florianova, Richard Margolese, Sinziana Dumitra, Thierry Muanza, Annie Carbonneau, Cristiano Ferrario, Jean Francois Boileau
Summary: This study demonstrates that sentinel lymph node biopsy alone for patients who convert to pathologic node-negativity after neoadjuvant chemotherapy is associated with low short-term axillary recurrence rates. Additional follow-up data from prospective clinical trials are needed to confirm long-term oncologic safety and optimal local therapy recommendations.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Oncology
Brittany L. Murphy, James W. Jakub, Malke Asaad, Courtney N. Day, Tanya L. Hoskin, Elizabeth B. Habermann, Judy C. Boughey
Summary: In patients with clinically node-negative breast cancer undergoing neoadjuvant chemotherapy, the presence of a positive sentinel lymph node is most commonly identified as the first node removed by the surgeon, and typically by the third sentinel node. This suggests that removal of additional sentinel lymph nodes beyond the first three does not provide additional diagnostic value.
ANNALS OF SURGICAL ONCOLOGY
(2021)