The lymph node status and tumor size are independent prognostic factors in tumors with invasion of the muscularis propria and in tumors with invasion of subserosa. T2 lesions have smaller size, lower rate of lymph node metastasis and therefore better prognosis than T3.

Objectives: Describe the frequency and factors associated with the indication of Sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) and the impact of SLNB on prognosis. Methods: Retrospective cohort study of women with breast cancer submitted to NACT from january 2013 to july 2015 at Hospital do Cancer III of the National Cancer Institute (HCIII/INCA). The data were collected in electronic and physical records. This study was approved by INCA's ethics and research committee. Results: A total of 783 women with mean age of 52 years (±11) were included. The majority were diagnosed with clinical stage IIIA (23%) and IIIB (33%), and with a Luminal A subtype (ER+ and / or PR+, HER2-) (52%). After NACT, complete response was observed in 15% and partial in 58%. Mastectomy was performed in 85% of the women, and 25% were submitted to SLNB (alone 14% and SLNB + Lymphadenectomy 11%). The factors associated with SLNB were: Initial clinical stage (OR = 6.22 95%CI 4.28-9.06) and complete response to NACT (OR=1.96 95%CI 1.29-2.97). In the follow-up, were observed 23% of recurrence /metastasis and 13% of death. After adjustment (cT, cN and NACT response), there was no association between the performance of SLNB with recurrence/metastasis (HR=1.51 95%CI 0.93-2.46) and death (HR=1.48 95%CI 0.76-2.90). Conclusion: The indication of SLNB after NACT was associated with initial clinical stage and complete response to NACT. After adjustment, SLNB was not associated with prognosis.

Objective: To evaluate the survival of patients with metastatic breast tumors, with human epidermal growth factor (HER2) receptors, present and treated in Unit 3 of the National Cancer Institute. Methodology: Retrospective cohort study with women diagnosed and treated in Unit 3 of the National Cancer Institute, in the years 2008 and 2009 (n=2035). For this analysis, patients with HER2 positive at diagnosis, clinical staging I to III (n=412) and who progressed with metastasis in the follow-up period (n=92) were selected. In this group of patients, 15.2% did herceptin palliative and 84.8% did not. Results: Among the 92 positive Herb 2 patients who progressed with distant metastasis, 32.6% had bone or soft tissue, 62% visceral and 5.4% locoregional metastasis, respectively. The mean survival of the patients was 38.4 months. Among those taking Herceptin, the mean survival was 49.7 months, while those who did not were 35.9 months. Among 31 patients with bone metastasis, enrolled between 2007 and 2009, 5 (16%) did Herceptin and 31 (84%) did not. The mean survival was 51.3 months and 31.7 months, respectively. In general, those patients who did not take Herceptin had a 2.35-fold higher risk of death compared to those who did (HR=2.35 95%CI 1.12-4.95, p=0.024). Conclusion: The use of trastuzumab in the palliative treatment of Herb2 positive patients had an impact on survival in the present study, including isolated bone metastases.