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Internal Mammary Lymphadenopathy Does Not Impact Oncologic Outcomes in Patients Treated with Neoadjuvant Chemotherapy: Results from the I-SPY2 Clinical Trial.
Piltin, Mara A; Norwood, Peter; Ladores, Velle; Mukhtar, Rita A; Sauder, Candice A; Golshan, Mehra; Tchou, Julia; Rao, Roshni; Lee, Marie Catherine; Son, Jennifer; Reyna, Chantal; Hewitt, Kelly; Kuerer, Henry; Ahrendt, Gretchen; Greenwalt, Ian; Tseng, Jennifer; Postlewait, Lauren; Howard-McNatt, Marissa; Jaskowiak, Nora; Esserman, Laura J; Boughey, Judy C.
Afiliación
  • Piltin MA; Division of Breast and Melanoma Surgical Oncology, Department of Surgery, Mayo Clinic, Rochester, MN, USA. Piltin.mara@mayo.edu.
  • Norwood P; Quantum Leap Healthcare Collaborative, San Francisco, CA, USA.
  • Ladores V; Quantum Leap Healthcare Collaborative, San Francisco, CA, USA.
  • Mukhtar RA; Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
  • Sauder CA; Department of Surgery, UC Davis Comprehensive Cancer Center, Sacramento, CA, USA.
  • Golshan M; Department of Surgery, Yale Medicine, New Haven, CT, USA.
  • Tchou J; Division of Breast Surgery, Penn Medicine at University of Pennsylvania, Philadelphia, PA, USA.
  • Rao R; Division of Breast Surgery, Columbia University Medical Center, New York, NY, USA.
  • Lee MC; Moffitt Cancer Center Comprehensive Breast Program, Tampa, FL, USA.
  • Son J; Breast Surgical Oncology, MedStar Georgetown University Hospital, Washington, DC, USA.
  • Reyna C; Division of Surgical Oncology, Department of Surgery, Loyola University Medical Center, Mayowood, IL, USA.
  • Hewitt K; Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Nashvilee, TN, USA.
  • Kuerer H; Department of Breast Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA.
  • Ahrendt G; Breast Surgical Oncology, UC Health, Highlands Ranch, CO, USA.
  • Greenwalt I; Breast Surgical Oncology, MedStar Georgetown University Hospital, Washington, DC, USA.
  • Tseng J; Department of Surgery, City of Hope Orange County, Irvine, CA, USA.
  • Postlewait L; Division of Surgical Oncology, Department of Surgery, Emory University, Atlanta, GA, USA.
  • Howard-McNatt M; Department of Surgical Oncology, Wake Forest, Winston-Salem, NC, USA.
  • Jaskowiak N; Department of Surgery, University of Chicago, Chicago, IL, USA.
  • Esserman LJ; Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
  • Boughey JC; Division of Breast and Melanoma Surgical Oncology, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Ann Surg Oncol ; 2024 Jul 09.
Article en En | MEDLINE | ID: mdl-38980586
ABSTRACT

BACKGROUND:

Internal mammary lymphadenopathy (IML) plays a role in breast cancer stage and prognosis. We aimed to evaluate method of IML detection, how IML impacts response to neoadjuvant chemotherapy (NAC), and oncologic outcomes.

METHODS:

We evaluated patients enrolled in the I-SPY-2 clinical trial from 2010 to 2022. We captured the radiographic method of IML detection (magnetic resonance imaging [MRI], positron emission tomography/computed tomography [PET/CT], or both) and compared patients with IML with those without. Rates of locoregional recurrence (LRR), distant recurrence (DR) and event-free survival (EFS) were compared by bivariate analysis.

RESULTS:

Of 2095 patients, 198 (9.5%) had IML reported on pretreatment imaging. The method of IML detection was 154 (77.8%) MRI only, 11 (5.6%) PET/CT only, and 33 (16.7%) both. Factors associated with IML were younger age (p = 0.001), larger tumors (p < 0.001), and higher tumor grade (p = 0.027). Pathologic complete response (pCR) was slightly higher in the IML group (41.4% vs. 34.0%; p = 0.03). There was no difference in breast or axillary surgery (p = 0.41 and p = 0.16), however IML patients were more likely to undergo radiation (68.2% vs. 54.1%; p < 0.001). With a median follow up of 3.72 years (range 0.4-10.2), there was no difference between IM+ versus IM- in LRR (5.6% vs. 3.8%; p = 0.25), DR (9.1% vs. 7.9%; p = 0.58), or EFS (61.6% vs. 57.2%; p = 0.48). This was true for patients with and without pCR.

CONCLUSIONS:

In this large cohort of patients treated with NAC, outcomes were not negatively impacted by IML. We demonstrated that IML influences treatment selection but is not a poor prognostic indicator when treated with modern NAC and multidisciplinary disease management.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 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 Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos