Luminal A Breast Cancer: How Feasible is Omitting Axillary Dissection Without Neoadjuvant Therapy

IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Cemil Yüksel, Bülent Aksel, Lütfi Doğan
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Abstract

Background. Luminal A breast cancer has a good prognosis and the criteria for adjuvant and neoadjuvant chemotherapy (NAC) are not clear. The aim of this study was to present our results of upfront surgery and long-term survival in luminal A tumors as well as the rates of protection from axillary dissection. Material and Methods. 271 Luminal A breast cancer patients who had operated at our center were evaluated retrospectively. In patients with 2 or less sentinel lymph node (SLN) positivity who did not receive neoadjuvant therapy and underwent breast-conserving surgery, axillary lymph node dissection was omitted (OAD). Axillary lymph node dissection (ALND) was performed in patients with positive SLN who did not meet these criteria (axillary dissection after sentinel/ADAS). Results. While Sentinel Lymph Node Biopsy (SLNB) was performed in 212 (77.9%) patients, SLNB + Axillary Dissection (AD) was performed in 58 (21.3%), and direct axillary dissection was performed in 1 (0.8%) patient. OAD was applied to 18 (23.6%) of the positive patients. Discussion/Conclusions. ALND rates are still strikingly high in luminal A breast cancer treatment, despite the disease’s milder clinical course. In order to avoid complications of axillary dissection, patients should be considered for NAC as much as possible. Novel neoadjuvant or other therapy options are also required.

Abstract Image

腔内A型乳腺癌:在没有新辅助治疗的情况下省略腋窝清扫的可行性如何?
背景:A腔乳腺癌预后良好,辅助化疗和新辅助化疗(NAC)标准尚不明确。本研究的目的是展示我们在A腔肿瘤的前期手术和长期生存的结果,以及腋窝清扫的保护率。材料与方法回顾性分析271例在我中心手术的A腔乳腺癌患者。未接受新辅助治疗并行保乳手术的2个及以下前哨淋巴结(SLN)阳性患者,省略腋窝淋巴结清扫(OAD)。不符合这些标准(前哨/ADAS后腋窝淋巴结清扫)的SLN阳性患者进行腋窝淋巴结清扫(ALND)。结果:前哨淋巴结活检(SLNB) 212例(77.9%),SLNB +腋窝清扫(AD) 58例(21.3%),直接腋窝清扫1例(0.8%)。阳性患者中18例(23.6%)应用OAD。讨论和结论。尽管该疾病的临床病程较轻,但在腔A乳腺癌治疗中,ALND的发生率仍然非常高。为避免腋窝夹层并发症,患者应尽可能考虑行NAC。还需要新的新辅助或其他治疗方案。
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来源期刊
Breast Journal
Breast Journal 医学-妇产科学
CiteScore
4.00
自引率
0.00%
发文量
47
审稿时长
4-8 weeks
期刊介绍: The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.
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