Axillary lymph node count is lower after neoadjuvant chemotherapy

Neuman, Heather B.; Carey, Lisa A.; Ollila, David W.; Livasy, Chad; Calvo, Benjamin F.; Meyer, Anthony A.; Kim, Hee Jin; Meyers, Michael O.; Dees, E. Claire; Collichio, Fran A.; Sartor, Carolyn I.; Moore, Dominic T.; Sawyer, Lynda R.; Frank, Jill; Klauber-DeMore, Nancy

doi:10.1016/j.amjsurg.2005.08.041

Cited by 64 publications

(43 citation statements)

References 9 publications

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“…It is suggested that at least 10 lymph nodes to be taken out for adequate axillary staging (Thain et al, 1998;Somner et al, 2004). It is stated that the number of ALN of the patients implied ALND after NAC is significantly fewer than the number in the patients having surgery without chemotheraphy (Neuman et al, 2006;Belanger et al, 2008). In our batch the number of ALN taken out in NAC group was significantly fewer than the primary surgery group, and this is accordant with the literature.…”

Section: Discussionsupporting

confidence: 88%

“…In literature local recurrence rate is stated between 7.9% and 34%; this rate is 7.7% in our batch and this is compatible with the literature. Neuman et al state that axillary recurrence is not determined in the patients during their 72-month follow up after taken out lymph nodes under 10 and they proposed that the surgical technique they applied is sufficient (Neuman et al, 2006). In our study axillary recurrence is not observed in any patients recieved NAC and taken out lymph nodes under 10 during their 36-month follow up.…”

Section: Discussionsupporting

confidence: 37%

“…Neuman et al (2006) do not find a difference in terms of the total number of lymph nodes taken out, they determine lymph nodes under 10 in significantly more patients received NAC (Neuman et al, 2006). Boughey et al (2014) state that the average number of lymph nodes is more in NAC group than primary surgery group and the rate of determining rate of lymph nodes under 10 in both groups is equal in their study (Boughey et al, 2014).…”

Section: Discussionmentioning

confidence: 90%

“…Accordingly, it is stated that NAC can reduce the number and size of ALN causing lymphocytic toxicity, complete fibrotic involution and obliteration in tumor metastases in ALNs. Another possibility is the opinion that NAC has a cytotoxic effect on lymphocytes that formed a large proportion of lymph node cortex and that it can directly obliterate lymph nodes (Neuman et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of Neoadjuvant Chemotherapy on Axillary Lymph Node Positivity and Numbers in Breast Cancer Cases

Uyan

Koca²,

Yürüker³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 37%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Neoadjuvant Chemotherapy on Axillary Lymph Node Positivity and Numbers in Breast Cancer Cases

Uyan

Koca²,

Yürüker³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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“…The use of neoadjuvant therapy can downstage lymph nodes, 64 leading to the retrieval of fewer lymph nodes from postneoadjuvant axillary lymph node dissection procedures. 65 This means that it is necessary to consider the timing of sentinel lymph node biopsy for axillary staging, because the use of neoadjuvant trastuzumab potentially may cause a loss of important staging information. 66 Although the current review has concentrated on the use of neoadjuvant trastuzumab in treating LABC, trastuzumab also has the potential to be used in other BC subtypes, including IBC 67 and early stage disease, including DCIS.…”

Section: Neoadjuvant Trastuzumabmentioning

confidence: 99%

Trastuzumab‐based neoadjuvant therapy in patients with HER2‐positive breast cancer

Chang

2010

Cancer

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Overexpression, or gene amplification, of the human epidermal growth factor receptor 2 (HER2) is evident in 20% to 25% of breast cancers. The biologic agent trastuzumab is an HER2-targeted monoclonal antibody that inhibits the proliferation of tumor cells and induces tumor cell death through multiple mechanisms of action. Currently, trastuzumab is approved for use in the adjuvant and metastatic settings. Trials combining trastuzumab with neoadjuvant chemotherapy suggest that patients with HER2-positive breast cancer also may benefit from preoperative trastuzumab. For this article, the author reviewed efficacy and safety data from key studies of patients who received neoadjuvant trastuzumab-based therapy. Studies were identified from literature searches of publication and congress databases. The results of 3 large phase 3 trials (the M. D. Anderson Cancer Center neoadjuvant trastuzumab trial, the Neoadjuvant Herceptin [NOAH] trial, and the German Breast Group/Gynecologic Oncology Study Group ''GeparQuattro'' trial) demonstrated that, compared with chemotherapy alone, neoadjuvant trastuzumab plus chemotherapy significantly increased pathologic complete response rates to as high as 65%. Improvements in disease-free, overall, and event-free survival also were reported in the NOAH trial. In addition to demonstrated efficacy, a low incidence of cardiac dysfunction suggests that neoadjuvant trastuzumab is both effective and well tolerated. Similar results have been reported in a range of phase 2 studies using different trastuzumab-based regimens. These encouraging data led the National Comprehensive Cancer Network to recommend treating patients who have operable, locally advanced, HER2-positive breast cancer with neoadjuvant paclitaxel plus trastuzumab followed by 5-fluorouracil, epirubicin, and cyclophosphamide plus trastuzumab. Cancer 2010;116:2856-67. V C 2010 American Cancer Society.KEYWORDS: neoadjuvant, trastuzumab, HER-2, chemotherapy, biologic, breast cancer, breast conservation surgery, lymph node management.Breast cancer (BC) is the most frequently diagnosed form of cancer among women in the United States. 1 Of the various subtypes of BC, tumors that have gene amplification or protein overexpression of human epidermal growth factor receptor 2 (HER2) are among the most aggressive and are associated with poor clinical outcomes compared with tumors that do not have HER2 overexpression. 2-4 Of the total number of patients diagnosed with BC in the United States, 20% to 25% will have tumors that exhibit HER2 gene amplification or protein overexpression. 2,5,6 Trastuzumab (Herceptin), a humanized, monoclonal antibody that blocks the activity of HER2, is the only anti-HER2 agent that is approved for adjuvant therapy in patients who have HER2-positive disease with either positive or negative lymph node status, estrogen receptor (ER)/progesterone receptor (PR)-negative disease, or a high-risk feature, either in combination with chemotherapy or as a single agent after chemotherapy. Adjuvant trastuzumab significantly imp...

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