Neoadjuvant Chemotherapy in Invasive Breast Cancer Results in a Lower Axillary Lymph Node Count

Bélanger, Julie; Soucy, Geneviève; Sidéris, Lucas; Leblanc, G; Drolet, Pierre; Mitchell, Andrew; Leclerc, Yves-Eugène; Beaudet, Julie; Dufresne, Michel-Pierre; Dubé, Pierre

doi:10.1016/j.jamcollsurg.2007.10.016

Cited by 48 publications

(33 citation statements)

References 21 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%

“…When tumor and nodal staging examined; pathological tumor and pathological node staging in NAC group was significantly lower than that of the primary surgery group and this is compatible with the literatüre (Belanger et al, 2008).…”

Section: Discussionsupporting

confidence: 85%

“…Belenger et al find a little difference between the patients recieved NAC and had primary surgery in terms of the number of lymph nodes taken out by axillary dissection, but determine lymph nodes under 10 in significantly more patients received NAC (Belanger et al, 2008). 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).…”

Section: Discussionmentioning

confidence: 98%

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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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

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 other aim of NAC is to increase the rate of breast conservation surgery which has less morbidity compared to total breast removal [1,6]. At the time of diagnosis, there may be occult metastasis so that preoperative chemotherapy can prevent progression at these metastatic foci and increase chances of survival [7].…”

Section: Introductionmentioning

confidence: 99%

“…At the time of diagnosis, there may be occult metastasis so that preoperative chemotherapy can prevent progression at these metastatic foci and increase chances of survival [7]. Furthermore, preoperative chemotherapy facilitates monitoring of tumor response in vivo, so that when there is resistance to a specific chemotherapy another cytostatic agent may be administered [1,6,8].…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant chemotherapy for locally advanced breast cancer: a single center experience

et al. 2009

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Neoadjuvant chemotherapy (NAC) is one of the treatment options for patients with locally advanced breast cancer (LABC). Preoperative chemotherapy potentially may reduce the extent of the surgery and offers the opportunity to assess the chemosensitivity of the tumor in vivo. Herein, we evaluated the results of NAC in Turkish LABC patients. We retrospectively analyzed 73 LABC patients. Anthracycline/taxane-based chemotherapy regimens were administered. Patients were stratified according to age, menopausal status, type of surgery, response to the treatment, histopathological properties, and survival. After 3-6 cycles of chemotherapy, patients were re-staged radiologically and surgery was performed in operable patients. Adjuvant chemotherapy was administered as needed. The median age was 45 (29-93) at the time of diagnosis. Sixteen percentage of patients were younger than 35 years of age and 45.2% were premenopausal. Median follow-up time was 20.2 months. Sixty-seven out of 73 patients responded to therapy (89%). Breast conserving surgery was possible in the 15% of the patients. In histopathological analysis, lymph node invasion was detected in 85%. The estrogen (ER) and progesterone (PR) receptor were positive in 78.1% and c-erb-B2 was positive in 17.5% of patients. The median disease-free survival (DFS) was 44 months (SE: 9; %95 CI: 27.1-60.8), overall survival (OS) was not reached at the time of analysis. Three-year DFS and OS were 58% and 91.9%, respectively. In a multivariate Cox regression analyses; no demographic or pathologic prognostic parameter predicted overall survival. In recent years, NAC in breast cancer has become a viable treatment option for patients with LABC. NAC is not commonly applied in Turkey. The response rate to NAC in Turkish breast cancer patients is encouragingly high. Broader efforts should be made to evaluate breast cancer patients preoperatively at tumor boards for proper treatment sequence.

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Number of lymph nodes identified at axillary dissection

Boughey

Donohue

Jakub

et al. 2010

Cancer

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BACKGROUND:Several reports have shown a significantly lower number of axillary lymph nodes (AxLNs) found at axillary lymph node dissection (ALND) after neoadjuvant chemotherapy. The objective of the current study was to investigate the factors affecting the number of AxLNs identified at ALND. METHODS: Medical records of patients seen at the study institution, a tertiary center, from 2004 to 2007 who underwent ALND for breast cancer were reviewed. RESULTS: Among the 698 patients who met study criteria, the mean number of AxLNs resected was 20.4. There were 649 (93%) patients with at least 10 AxLNs recovered. Seventy-one (10%) patients received neoadjuvant chemotherapy and 627 (90%) underwent surgical resection first. The mean number of AxLNs in the patients treated with neoadjuvant chemotherapy was 21.9 (range, 4-56 AxLNs) compared with 20.2 (range, 5-65 AxLNs) in the group treated with surgical resection first (P ¼.13). The number of patients with <10 AxLNs found at ALND was 44 of 627 (7.0%) in the surgical resection first group and 5 of 71 (7.0%) in the neoadjuvant chemotherapy group (P ¼ 1.0). The mean number of AxLNs was higher in the 599 (86%) ALNDs performed at the study center compared with the 99 cases from outside institutions (21.2 vs 15.2 AxLNs; P <.001). Among the cases performed at the study institution, 367 (61%) were performed by surgeons with oncologic training and 232 (39%) were not. Surgical oncologists recovered an average of 23 AxLNs, which was significantly higher than the 18.4 resected by the remaining surgeons (P <.001). CONCLUSIONS: The number of AxLNs recovered at ALND does not appear to be affected by neoadjuvant chemotherapy. Surgeons with oncologic training appear to retrieve more AxLNs. Cancer 2010;116:3322-9.

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Neoadjuvant Chemotherapy in Invasive Breast Cancer Results in a Lower Axillary Lymph Node Count

Cited by 48 publications

References 21 publications

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

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

Neoadjuvant chemotherapy for locally advanced breast cancer: a single center experience

Number of lymph nodes identified at axillary dissection

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