Omitting Axillary Dissection in Triple-Negative and HER2-Overexpressed Breast Cancers With Positive Sentinel Lymph Nodes During Upfront Surgery: SENATURK-OTHELLO Study

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-02-08 DOI:10.1016/j.clbc.2025.02.002

Neslihan Cabıoğlu , Hasan Karanlık , Vahit Özmen , Mustafa Tükenmez , Abdullah İğci , Yusuf E. Aytin , Hande Köksal , Halime Mutlu , Süleyman Bademler , Cihan Uras , Onur Dülgeroğlu , Enver Özkurt , Selman Emiroğlu , Mahmut Müslümanoğlu , Nilüfer Yıldırım , Atakan Sezer , Güldeniz Karadeniz Çakmak , Hakan Balbaloğlu , İsmail Zihni , Bahadır M. Güllüoğlu

{"title":"Omitting Axillary Dissection in Triple-Negative and HER2-Overexpressed Breast Cancers With Positive Sentinel Lymph Nodes During Upfront Surgery: SENATURK-OTHELLO Study","authors":"Neslihan Cabıoğlu , Hasan Karanlık , Vahit Özmen , Mustafa Tükenmez , Abdullah İğci , Yusuf E. Aytin , Hande Köksal , Halime Mutlu , Süleyman Bademler , Cihan Uras , Onur Dülgeroğlu , Enver Özkurt , Selman Emiroğlu , Mahmut Müslümanoğlu , Nilüfer Yıldırım , Atakan Sezer , Güldeniz Karadeniz Çakmak , Hakan Balbaloğlu , İsmail Zihni , Bahadır M. Güllüoğlu","doi":"10.1016/j.clbc.2025.02.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Randomized trials including ACOSOG Z0011 and SENOMAC mostly included patients with hormone receptor-positive breast cancer, but a limited number of patients with aggressive tumor biology. Therefore, we assessed the oncological safety of omitting axillary dissection in patients with SLN-positive HER2-positive or triple-negative breast cancer at upfront surgery.</div></div><div><h3>Materials and Methods</h3><div>This retrospective cohort study included patients with clinically node-negative HER2-positive and triple-negative breast cancer who had sentinel lymph node biopsy (SLNB) alone with pN+ disease. Almost all patients (97.5%) received nodal irradiation.</div></div><div><h3>Results</h3><div>Between 2015 and 2020, 118 patients with HER2-positive (<em>n</em> = 79, 67%) and triple-negative (<em>n</em> = 39, 33%) tumors were included in the study from 8 centers. Of those, 94.9% were cT1-2 and 72% underwent breast-conserving surgery. Most patients (<em>n</em> = 98, 83.1%) had 1 metastatic sentinel lymph node. Among those with involved sentinel lymph nodes, 59 (50%) had macrometastasis, 43 (36.4%) had micrometastasis and 16 (13.6%) had isolated tumor cells. After a median follow-up of 53 months, the locoregional recurrence rate was 2.5% without any axillary recurrence, and systemic recurrence rate was 11.9%. Factors associated with worse disease-free survival were having a cT2-3 stage and a triple-negative subtype disease. Having triple-negative tumor was the only significant factor associated with worse disease-specific survival.</div></div><div><h3>Conclusion</h3><div>Patients with cN0 HER2-positive and triple-negative breast cancer with low-volume axillary metastases treated with upfront SLNB-alone showed excellent local control with nodal irradiation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 5","pages":"Pages 455-463"},"PeriodicalIF":2.9000,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical breast cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S152682092500031X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Randomized trials including ACOSOG Z0011 and SENOMAC mostly included patients with hormone receptor-positive breast cancer, but a limited number of patients with aggressive tumor biology. Therefore, we assessed the oncological safety of omitting axillary dissection in patients with SLN-positive HER2-positive or triple-negative breast cancer at upfront surgery.

Materials and Methods

This retrospective cohort study included patients with clinically node-negative HER2-positive and triple-negative breast cancer who had sentinel lymph node biopsy (SLNB) alone with pN+ disease. Almost all patients (97.5%) received nodal irradiation.

Results

Between 2015 and 2020, 118 patients with HER2-positive (n = 79, 67%) and triple-negative (n = 39, 33%) tumors were included in the study from 8 centers. Of those, 94.9% were cT1-2 and 72% underwent breast-conserving surgery. Most patients (n = 98, 83.1%) had 1 metastatic sentinel lymph node. Among those with involved sentinel lymph nodes, 59 (50%) had macrometastasis, 43 (36.4%) had micrometastasis and 16 (13.6%) had isolated tumor cells. After a median follow-up of 53 months, the locoregional recurrence rate was 2.5% without any axillary recurrence, and systemic recurrence rate was 11.9%. Factors associated with worse disease-free survival were having a cT2-3 stage and a triple-negative subtype disease. Having triple-negative tumor was the only significant factor associated with worse disease-specific survival.

Conclusion

Patients with cN0 HER2-positive and triple-negative breast cancer with low-volume axillary metastases treated with upfront SLNB-alone showed excellent local control with nodal irradiation.

查看原文本刊更多论文

SENATURK-OTHELLO研究：在前哨淋巴结阳性的三阴性和her2过表达乳腺癌术前省略腋窝清扫

目的：包括ACOSOG Z0011和SENOMAC在内的随机试验主要包括激素受体阳性乳腺癌患者，但有限数量的肿瘤生物学侵袭性患者。因此，我们评估了sln阳性her2阳性或三阴性乳腺癌患者在术前省略腋窝清扫的肿瘤学安全性。材料和方法：本回顾性队列研究纳入了单纯行前哨淋巴结活检（SLNB）合并pN+疾病的临床淋巴结阴性her2阳性和三阴性乳腺癌患者。几乎所有患者（97.5%）接受了淋巴结照射。结果：2015年至2020年期间，来自8个中心的118例her2阳性（n = 79, 67%）和三阴性（n = 39, 33%）肿瘤患者纳入研究。其中94.9%为cT1-2, 72%为保乳手术。大多数患者（n = 98, 83.1%）有1个转移前哨淋巴结。前哨淋巴结受累者中，大转移59例（50%），微转移43例（36.4%），分离肿瘤细胞16例（13.6%）。中位随访53个月后，局部复发率为2.5%，无腋窝复发，全身复发率为11.9%。与较差的无病生存率相关的因素是cT2-3期和三阴性亚型疾病。三阴性肿瘤是唯一与较差的疾病特异性生存率相关的显著因素。结论：cN0 her2阳性和三阴性乳腺癌伴小体积腋窝转移的患者在淋巴结照射下局部控制良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.