Trends in management and related outcomes for occult primary breast cancer.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2024-10-13 DOI:10.1007/s10549-024-07500-w

M LaBella, R E Lile-King, C B Agala, P M Spanheimer, D W Ollila, K K Gallagher, J M Selfridge

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引用次数: 0

Abstract

Purpose: Occult Primary Breast Cancer (OPBC) is a rare clinical condition in which breast cancer is located within the axillary lymph nodes, but no primary tumor is identified in the breast. We evaluated trends of neoadjuvant chemotherapy (NAC) use and subsequent axillary procedures in OPBC as well as outcomes for these patients.

Methods: The National Cancer Database was used to identify adult women with cT0N1-3M0 breast cancer between 2012 to 2021 that underwent axillary lymph node surgery. Kaplan-Meier curves were used to evaluate survival between groups.

Results: 2759 patients met inclusion criteria. 86.2% underwent ALND alone in 2012, and this decreased to 65.6% in 2021. 4.7% underwent SLNB alone in 2012 and this increased to 16.2% in 2021 (p < 0.001). For patients who had undergone NAC, 46.4% of ALND patients had nodal pathologic complete response (nPCR), compared to 42.7% of SLNB + ALND and 66.4% of SLNB only patients. For patients with nPCR, there was no difference in overall survival (OS) between ALND, SLNB + ALND, and SLNB alone groups (p = 0.9912).

Conclusion: Most OPBC patients were treated with ALND, with a modest increase towards SLNB use during the study period. There was no difference in OS with respect to axillary surgical procedure in our population for those with nPCR after NAC. This suggests that for carefully selected OPBC patients with an excellent clinical response to NAC and negative SLNB, omission of ALND may be considered.

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隐匿性原发性乳腺癌的管理趋势和相关结果。

目的：隐匿性原发性乳腺癌（OPBC）是一种罕见的临床症状，即乳腺癌位于腋窝淋巴结内，但在乳房内未发现原发肿瘤。我们评估了OPBC患者使用新辅助化疗（NAC）和后续腋窝手术的趋势以及这些患者的预后：方法：我们利用美国国家癌症数据库（National Cancer Database）来识别2012年至2021年间患有cT0N1-3M0乳腺癌并接受腋窝淋巴结手术的成年女性患者。结果：2759 名患者符合纳入标准。2012年，86.2%的患者仅接受了ALND手术，2021年这一比例降至65.6%。2012年有4.7%的患者接受了单纯SLNB治疗，到2021年这一比例将增至16.2%（P 结论：大多数OPBC患者接受了ALND治疗，而2021年这一比例将降至65.6%：大多数 OPBC 患者接受了 ALND 治疗，在研究期间，SLNB 的使用略有增加。在我们的研究人群中，NAC后有nPCR的患者在腋窝手术方面的OS没有差异。这表明，对于经过严格筛选、对 NAC 临床反应极佳且 SLNB 阴性的 OPBC 患者，可以考虑不进行 ALND。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.