Your browser doesn't support javascript.
loading
Assessing the Burden of Nodal Disease for Breast Cancer Patients with Clinically Positive Nodes: Hope for More Limited Axillary Surgery.
Angarita, Stephanie; Ye, Linda; Rünger, Dennis; Hadaya, Joseph; Baker, Jennifer L; Dawson, Nicole; Thompson, Carlie K; Lee, Minna K; Attai, Deanna J; DiNome, Maggie L.
Afiliación
  • Angarita S; Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • Ye L; Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • Rünger D; Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • Hadaya J; Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • Baker JL; Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • Dawson N; Department of Pathology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • Thompson CK; Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • Lee MK; Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • Attai DJ; Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  • DiNome ML; Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. mdinome@mednet.ucla.edu.
Ann Surg Oncol ; 28(5): 2609-2618, 2021 May.
Article en En | MEDLINE | ID: mdl-33084993
BACKGROUND: Omission of axillary lymph node dissection (ALND) is accepted for patients with one or two positive sentinel nodes, and studies are focusing on clinically node-positive patients who have been downstaged with neoadjuvant chemotherapy (NAC). Evidence is lacking for patients with positive nodes who undergo surgery upfront. These patients are assumed to have a higher burden of nodal disease such that ALND remains the standard of care. METHODS: Patients who underwent ALND for breast cancer between 2010 and 2019 at the authors' institution were retrospectively identified. Those with clinical N1 disease were included in the study. Patients who received NAC and those who had surgery for sentinel node positive disease or axillary recurrence were excluded. Clinical and pathologic factors associated with nodal stage were evaluated. RESULTS: Of 111 patients who met the inclusion criteria, 61.3% had a palpable node on exam, and 41.4% ultimately had pN1 disease. Most of the tumors were estrogen receptor (ER)-positive (91.5%), and 21.7% of the tumors were invasive lobular cancers. Lobular histology, tumor size, and metastasis size were associated with higher nodal stage. In the multivariable analysis, the patients with nodal metastasis larger than 10 mm had significantly lower odds of having pN1 disease (odds ratio 0.12; 95% confidence interval 0.02-0.69; p = 0.02). In a subset analysis of patients with palpable nodes, tumor size and histology remained significantly associated with nodal stage. CONCLUSION: More than 40% of breast cancer patients with clinically positive nodes had minimal nodal disease (pN1) at surgery. Additionally, palpable nodes on exam did not predict higher nodal stage. A subset of patients with clinically positive nodes may be identified who can potentially be spared the morbidity of ALND.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama Tipo de estudio: Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama Tipo de estudio: Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos