The Molecular Subtype Classification Is a Determinant of Sentinel Node Positivity in Early Breast Carcinoma

Reyal, Fabien; Rouzier, Roman; Depont-Hazelzet, Berenice; Bollet, Marc A.; Pierga, Jean‐Yves; Alran, S.; Salmon, Rémy; Fourchotte, Virginie; Vincent‐Salomon, Anne; Sastre-Garau, Xavier; Antoine, Martine; Uzan, Serge; Sigal‐Zafrani, Brigitte; Rycke, Yann De

doi:10.1371/journal.pone.0020297

Cited by 125 publications

(97 citation statements)

References 29 publications

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“…These findings were in accordance with previous reports [7][8][9][10][11][12][13]. Our study could not find out the association between molecular subtype and SLN metastasis, in contrast with previous reports [3,6,[14][15][16][17][18][19][20][21][22]. Possible explanation to the discrepancy between previous reports and our results is that the distribution in among subtype might affect the results: HER 2 type was very few (7.0%), and this seems to be the reason why low frequency of SLN metastasis in HER 2 subtype was shown in our study.…”

Section: Discussionsupporting

confidence: 86%

“…A various clinicopathological factors have been identified as independent predictors of axillary lymph node metastasis in early stage breast cancer [6]. These include clinical palpability [7][8][9][10], tumor size [7][8][9][10][11][12][13], lymphatic or vascular involvement [7][8][9][10][11]13], tumor grade [7,10], hormone receptor (HR) status [12,13], age [8,11,12], and molecular subtypes [3,6,[14][15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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The Association between Sentinel Lymph Node Metastasis and Ki-67 Labeling Index

Koyama

Sakata²,

Sakata³

et al. 2013

ABCR

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Background: The purpose of this study was to elucidate the association between sentinel lymph node (SLN) metastasis and Ki67 labeling index and to elucidate whether Ki-67 was useful or not for prediction of SLN metastasis in breast cancer. Methods: We identified 343 invasive breast cancer patients with sentinel lymph node biopsy (SLNB) from 2003 to 2012. The association between SLN status and clinicopathological features, molecular subtypes and Ki-67 labeling index were evaluated. Results: SLN metastasis was detected in 79 patients (23.0%). SLN metastasis was significantly associated with clinical T-stage (p = 0.0003), lymphovascular involvement (LVI) (p < 0.0001). Ki-67 labeling index of primary tumor was significantly lower in SLN positive patients (p = 0.0331), and Ki-67 cut-off point of 7.5% was useful for dividing SLN positive from negative (p = 0.0197). Conclusion: Low value of Ki-67 labeling index, in addition to progression of clinical T-stage and presence of LVI, is significantly associated with SLN metastasis, and it seems to be useful to consider Ki-67 labeling index for SLN metastasis prediction.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

The Association between Sentinel Lymph Node Metastasis and Ki-67 Labeling Index

Koyama

Sakata²,

Sakata³

et al. 2013

ABCR

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“…The risk of lymph node lesions increased in cases of cancers exhibiting HER2 overexpression [27,30]. However, it was notably lower among patients with luminal A type of cancer and triple negative tumors [31,32] (in our study this proportion was 26.4% and 32.2%, respectively).…”

Section: Discussioncontrasting

confidence: 54%

“…Due to a high proportion of lymph node metastases noted among patients with luminal B1 and HER2-positive cancers (exceeding 50% of the total number of cases -vs 38.6% and 42.1%, respectively, in our material), Reyal et al suggested the need for consideration of SLNB in these groups of patients [30]. However, possible changes in patient qualification for this type of procedure proposed by the authors have not been widely accepted.…”

Section: Discussionmentioning

confidence: 71%

Prevalence of biological types of breast cancer and their influence on disease staging and therapeutic management – a single-center study

Nowikiewicz¹,

Chmielowska²,

Andrusewicz³

et al. 2017

pjp

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According to the St. Gallen 2011 consensus, proper qualification of breast cancer patients for treatment requires taking into consideration the division into biological types of neoplasms. The goal of this work was to assess the prevalence of all biological types of breast cancer in the population of Kuyavian-Pomeranian province. We determined the influence of particular types of neoplasms on the degree of disease progression and the choice of therapeutic management. The study was conducted on a group of 2653 patients treated surgically due to malignant breast tumors in the Oncology Centre in Bydgoszcz. In the analyzed clinical material we determined the biological type of cancer as well as other prognostic factors. The most commonly identified types of cancer were luminal B1 type (38.4%) and luminal A type (27.4% of cases), followed by a triple-negative type, luminal B2 type and HER2-positive type (respectively: 11.4%, 10.2%, and 6.9% of patients). Estrogen receptors were present in 81.1% and progesterone receptors in 71.4% of subjects. HER2 overexpression was identified in 17.3% of patients. Routine use of a biology-based division into cancer types influences the choice of anti-cancer treatment. Diagnosis of luminal A type of tumor more commonly than other biological types of cancer coexists with lower clinical and pathological disease staging. It allows for more frequent use of sparing surgical techniques in patients. It also makes systemic neoadjuvant chemotherapy unnecessary in the majority of patients (differences in such cases exhibit statistical significance of p < 0.0001).

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“…Furthermore, several studies have suggested that the triplenegative tumor subtype may predict a lower risk of nodal involvement. [35][36][37][38][39] Because biology and systemic therapy influence the natural evolution of disease, the indications for axillary surgery should take these factors into consideration. Single-center studies do not demonstrate any benefits in performing axillary surgery, but meta-analyses lead to a different conclusion.…”

Section: Author's Personal Copymentioning

confidence: 99%

Does Conservative Surgery for Breast Carcinoma Still Require Axillary Lymph Node Evaluation? A Retrospective Analysis of 1156 Consecutive Women With Early Breast Cancer

Marrazzo

Damiano

Taörmina³

et al. 2017

Clinical Breast Cancer

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We performed a retrospective analysis of 1156 patients affected by early breast cancer in order to estimate the real incidence of patients with T1 tumors presenting > 2 metastatic lymph nodes. The advantage of axillary surgery seems to be limited only to a specific subgroup of T1 patients who are undergoing conservative surgery plus radiotherapy. Background: The role of axillary surgery for early breast carcinoma treated with conservative surgery and radiotherapy is currently the subject of considerable investigation. Recent studies have supported the noninferiority of avoiding axillary surgery in terms of overall survival when sentinel lymph node biopsy (SLNB) presents 2 positive lymph nodes, thus sparing the patients from complications. There are some ongoing studies investigating the possibility of omitting SLNB. Axillary study seems to be sufficiently replaced by SLNB for staging the disease. Axillary surgery maintains a therapeutic role in the presence of > 2 metastatic lymph nodes at SLNB. Patients and Methods: We performed a retrospective analysis of 1156 patients with early breast cancer to estimate the real incidence of patients with T1 tumors presenting > 2 metastatic lymph nodes. Results: Of the 1156 cases, only 106 (9.2%) had > 2 axillary metastatic lymph nodes. More specifically, 38 (4.3%) of 884 T1 cases, and 6 (2.3%) of 257 of T1b cases had > 2 metastatic lymph nodes. Conclusion: The advantage of axillary surgery seems to be limited only to a specific subgroup of T1 patients who are undergoing conservative surgery plus radiotherapy. The ongoing studies on avoiding SLNB will likely prove the noninferiority of omitting biopsy because these studies are conducted in the whole population of early breast cancers. It is necessary to identify more accurately the subpopulation of patients who may benefit from axillary surgery.

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The Molecular Subtype Classification Is a Determinant of Sentinel Node Positivity in Early Breast Carcinoma

Cited by 125 publications

References 29 publications

The Association between Sentinel Lymph Node Metastasis and Ki-67 Labeling Index

The Association between Sentinel Lymph Node Metastasis and Ki-67 Labeling Index

Prevalence of biological types of breast cancer and their influence on disease staging and therapeutic management – a single-center study

Does Conservative Surgery for Breast Carcinoma Still Require Axillary Lymph Node Evaluation? A Retrospective Analysis of 1156 Consecutive Women With Early Breast Cancer

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