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Targeted axillary biopsy and sentinel lymph node biopsy for axillary restaging after neoadjuvant chemotherapy.
Gurleyik, Gunay; Aksu, Sibel Aydin; Aker, Fügen; Tekyol, Kubra Kaytaz; Tanrikulu, Eda; Gurleyik, Emin.
Afiliación
  • Gurleyik G; Department of Surgery, Health Science University, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
  • Aksu SA; Department of Radiology, Health Science University, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
  • Aker F; Department of Pathology, Health Science University, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
  • Tekyol KK; Department of Surgery, Health Science University, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
  • Tanrikulu E; Department of Surgery, Health Science University, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
  • Gurleyik E; Department of Surgery, Duzce University Medical Faculty, Duzce, Turkey.
Ann Surg Treat Res ; 100(6): 305-312, 2021 Jun.
Article en En | MEDLINE | ID: mdl-34136426
PURPOSE: Accurate restaging of the axilla after neoadjuvant chemotherapy (NAC) is an important issue to ensure deescalating axillary surgery in patients with initial metastatic nodes. We aimed to present our results of targeted axillary biopsy (TAB) combined with sentinel lymph node biopsy (SLNB) for axillary restaging after NAC. METHODS: In 64 breast cancer patients who underwent NAC, biopsy-proven positive nodes were marked with clips before NAC, and ultrasound-guided wire localization of clip-marked nodes was performed after NAC. Patients underwent TAB and SLNB for post-NAC axilla restaging. RESULTS: Identification rates of post-NAC TAB and SLNB were 98.4% and 87.5%, respectively (P = 0.033). Histopathology revealed a nodal pathologic complete response (pCR) rate of 47% in which axillary lymph node dissection (ALND) was avoided. TAB alone and SLNB alone detected residual disease in 29 (85.3%) and 20 (58.8%) patients (P = 0.029), respectively. Whereas rates of up to 97% had been achieved with a combination of TAB and SLNB. The pCR rates after NAC were 64.3% for human epidermal growth factor receptor 2 positive and triple-negative tumors and 13.6% in luminal tumors (P = 0.0002). CONCLUSION: Pathologic analysis following TAB combined with SLNB revealed the pCR rates to NAC in a considerable number of patients that provided de-escalation of axillary surgery. A combination of SLNB and TAB was found to be an accurate procedure in establishing residual nodal disease. This combined procedure in patients with initially positive nodes was a reliable method for post-NAC axillary restaging.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Ann Surg Treat Res Año: 2021 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Corea del Sur
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Ann Surg Treat Res Año: 2021 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Corea del Sur