An audit of patients undergoing neoadjuvant chemotherapy and analysis of nodal disease to guide management
Association of Breast Surgery ePoster Library. Nagy E. 05/13/19; 257045; P001
Dr. Eva Nagy
REGULAR CONTENT
Login now to access Regular content available to all registered users.
Abstract
Discussion Forum (0)
Rate & Comment (0)
P001
Topic: Axilla
Introduction: For patients recommended neo-adjuvant chemotherapy (NAC), current practice for involved lymph nodes (LNs) at diagnosis is performing Axillary node clearance's (ANC's).We have audited our practice to assess the level of axillary node disease on diagnostic ultrasound and post NAC pathology and reviewed how this information may guide management.MethodData was collected from breast-cancer patients who underwent NAC 2014-2018. All suspicious nodes were core biopsied. Further categorisation was performed for those with LN involvement at diagnosis along with tumour biology. Results 266 patients underwent NAC; pre-operative ultrasound nodal statuses included:·No LN involvement - 120 patients (Group1) - (Sentinel Node biopsy (SNB))·LN involvement - 146 patients (ANC):o 40 patients 1-2 LNs involved (Group2:low burden)o 106 patients≥3 LNs involved (Group3:high burden)GROUP 1:·19/120 patients had involved SNB's:·Majority (89%) had low disease burden·10 patients underwent ANC'so 3 had further disease·Total, 118 patients (98%) had no, or low disease burdenGROUP 2:·40 patients:o 14 patients had nodal PCRo 17 patients had 1-2 LN's residually involvedo 9 patients had≥3 LNs residually involved (8 were ER+)GROUP 3:·106 patients:o PCR in 33 patientso 20 patients reduction of LN involvemento 53 patients had high burden of axillary diseaseConclusion·Pre-NAC ultrasound is 93% accurate in identifying no or low burden axillary disease·This preliminary information could be used to inform future work in NAC patients with individualised axillary management pathways based on risk profile.
Topic: Axilla
Introduction: For patients recommended neo-adjuvant chemotherapy (NAC), current practice for involved lymph nodes (LNs) at diagnosis is performing Axillary node clearance's (ANC's).We have audited our practice to assess the level of axillary node disease on diagnostic ultrasound and post NAC pathology and reviewed how this information may guide management.MethodData was collected from breast-cancer patients who underwent NAC 2014-2018. All suspicious nodes were core biopsied. Further categorisation was performed for those with LN involvement at diagnosis along with tumour biology. Results 266 patients underwent NAC; pre-operative ultrasound nodal statuses included:·No LN involvement - 120 patients (Group1) - (Sentinel Node biopsy (SNB))·LN involvement - 146 patients (ANC):o 40 patients 1-2 LNs involved (Group2:low burden)o 106 patients≥3 LNs involved (Group3:high burden)GROUP 1:·19/120 patients had involved SNB's:·Majority (89%) had low disease burden·10 patients underwent ANC'so 3 had further disease·Total, 118 patients (98%) had no, or low disease burdenGROUP 2:·40 patients:o 14 patients had nodal PCRo 17 patients had 1-2 LN's residually involvedo 9 patients had≥3 LNs residually involved (8 were ER+)GROUP 3:·106 patients:o PCR in 33 patientso 20 patients reduction of LN involvemento 53 patients had high burden of axillary diseaseConclusion·Pre-NAC ultrasound is 93% accurate in identifying no or low burden axillary disease·This preliminary information could be used to inform future work in NAC patients with individualised axillary management pathways based on risk profile.
P001
Topic: Axilla
Introduction: For patients recommended neo-adjuvant chemotherapy (NAC), current practice for involved lymph nodes (LNs) at diagnosis is performing Axillary node clearance's (ANC's).We have audited our practice to assess the level of axillary node disease on diagnostic ultrasound and post NAC pathology and reviewed how this information may guide management.MethodData was collected from breast-cancer patients who underwent NAC 2014-2018. All suspicious nodes were core biopsied. Further categorisation was performed for those with LN involvement at diagnosis along with tumour biology. Results 266 patients underwent NAC; pre-operative ultrasound nodal statuses included:·No LN involvement - 120 patients (Group1) - (Sentinel Node biopsy (SNB))·LN involvement - 146 patients (ANC):o 40 patients 1-2 LNs involved (Group2:low burden)o 106 patients≥3 LNs involved (Group3:high burden)GROUP 1:·19/120 patients had involved SNB's:·Majority (89%) had low disease burden·10 patients underwent ANC'so 3 had further disease·Total, 118 patients (98%) had no, or low disease burdenGROUP 2:·40 patients:o 14 patients had nodal PCRo 17 patients had 1-2 LN's residually involvedo 9 patients had≥3 LNs residually involved (8 were ER+)GROUP 3:·106 patients:o PCR in 33 patientso 20 patients reduction of LN involvemento 53 patients had high burden of axillary diseaseConclusion·Pre-NAC ultrasound is 93% accurate in identifying no or low burden axillary disease·This preliminary information could be used to inform future work in NAC patients with individualised axillary management pathways based on risk profile.
Topic: Axilla
Introduction: For patients recommended neo-adjuvant chemotherapy (NAC), current practice for involved lymph nodes (LNs) at diagnosis is performing Axillary node clearance's (ANC's).We have audited our practice to assess the level of axillary node disease on diagnostic ultrasound and post NAC pathology and reviewed how this information may guide management.MethodData was collected from breast-cancer patients who underwent NAC 2014-2018. All suspicious nodes were core biopsied. Further categorisation was performed for those with LN involvement at diagnosis along with tumour biology. Results 266 patients underwent NAC; pre-operative ultrasound nodal statuses included:·No LN involvement - 120 patients (Group1) - (Sentinel Node biopsy (SNB))·LN involvement - 146 patients (ANC):o 40 patients 1-2 LNs involved (Group2:low burden)o 106 patients≥3 LNs involved (Group3:high burden)GROUP 1:·19/120 patients had involved SNB's:·Majority (89%) had low disease burden·10 patients underwent ANC'so 3 had further disease·Total, 118 patients (98%) had no, or low disease burdenGROUP 2:·40 patients:o 14 patients had nodal PCRo 17 patients had 1-2 LN's residually involvedo 9 patients had≥3 LNs residually involved (8 were ER+)GROUP 3:·106 patients:o PCR in 33 patientso 20 patients reduction of LN involvemento 53 patients had high burden of axillary diseaseConclusion·Pre-NAC ultrasound is 93% accurate in identifying no or low burden axillary disease·This preliminary information could be used to inform future work in NAC patients with individualised axillary management pathways based on risk profile.
Code of conduct/disclaimer available in General Terms & Conditions
{{ help_message }}
{{filter}}