Factors associated with complete pathological response in the axilla following primary chemotherapy
Association of Breast Surgery ePoster Library. Luther A. 05/13/19; 257063; P019
Ms. Alison Luther
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P019
Topic: Axilla
IntroductionManagement of the clinically positive axilla, down-staged to clinically negative by primary chemotherapy is controversial. The 2017 St Gallen consensus proposed sentinel lymph node biopsy (SLNB) alone, providing three negative sentinel nodes are identified, but this has not become standard practice. This study aims to identify factors associated with negative axillary lymph node histology in these patients.MethodRetrospective data was collected on breast cancer patients completing six cycles of primary chemotherapy, between 01/02/2014 and 31/01/2018. Patients were included if they were node positive on core biopsy histology prior to chemotherapy, down-staged to node negative on ultrasound, and underwent axillary lymph node dissection. ResultsOf 69 patients meeting the inclusion criteria, 46.3% (n=32) had pathological complete response (pCR) in the axilla. When complete radiological response in the breast occurred, 70.55% (12/17) of patients had axillary pCR, compared to 38.5% (20/52) where residual breast disease was seen radiologically (pConclusionThis study demonstrates that despite complete axillary radiological response following primary chemotherapy, over 50% of patients will have residual axillary disease. Patients with ER negative/HER2 positive disease had a significantly lower risk, however with limited further adjuvant treatment, thorough initial surgery is critical. Further consideration needs to be given therefore to usage of SLNB in these high-risk patients.Table 1: Receptor status of patients with axillary pCR ER PositiveER negativeHER2 Positive53.8 % (7/13)83% (10/12)HER2 Negative25% (7/28)50% (8/16) p2analysis
Topic: Axilla
IntroductionManagement of the clinically positive axilla, down-staged to clinically negative by primary chemotherapy is controversial. The 2017 St Gallen consensus proposed sentinel lymph node biopsy (SLNB) alone, providing three negative sentinel nodes are identified, but this has not become standard practice. This study aims to identify factors associated with negative axillary lymph node histology in these patients.MethodRetrospective data was collected on breast cancer patients completing six cycles of primary chemotherapy, between 01/02/2014 and 31/01/2018. Patients were included if they were node positive on core biopsy histology prior to chemotherapy, down-staged to node negative on ultrasound, and underwent axillary lymph node dissection. ResultsOf 69 patients meeting the inclusion criteria, 46.3% (n=32) had pathological complete response (pCR) in the axilla. When complete radiological response in the breast occurred, 70.55% (12/17) of patients had axillary pCR, compared to 38.5% (20/52) where residual breast disease was seen radiologically (pConclusionThis study demonstrates that despite complete axillary radiological response following primary chemotherapy, over 50% of patients will have residual axillary disease. Patients with ER negative/HER2 positive disease had a significantly lower risk, however with limited further adjuvant treatment, thorough initial surgery is critical. Further consideration needs to be given therefore to usage of SLNB in these high-risk patients.Table 1: Receptor status of patients with axillary pCR ER PositiveER negativeHER2 Positive53.8 % (7/13)83% (10/12)HER2 Negative25% (7/28)50% (8/16) p2analysis
P019
Topic: Axilla
IntroductionManagement of the clinically positive axilla, down-staged to clinically negative by primary chemotherapy is controversial. The 2017 St Gallen consensus proposed sentinel lymph node biopsy (SLNB) alone, providing three negative sentinel nodes are identified, but this has not become standard practice. This study aims to identify factors associated with negative axillary lymph node histology in these patients.MethodRetrospective data was collected on breast cancer patients completing six cycles of primary chemotherapy, between 01/02/2014 and 31/01/2018. Patients were included if they were node positive on core biopsy histology prior to chemotherapy, down-staged to node negative on ultrasound, and underwent axillary lymph node dissection. ResultsOf 69 patients meeting the inclusion criteria, 46.3% (n=32) had pathological complete response (pCR) in the axilla. When complete radiological response in the breast occurred, 70.55% (12/17) of patients had axillary pCR, compared to 38.5% (20/52) where residual breast disease was seen radiologically (pConclusionThis study demonstrates that despite complete axillary radiological response following primary chemotherapy, over 50% of patients will have residual axillary disease. Patients with ER negative/HER2 positive disease had a significantly lower risk, however with limited further adjuvant treatment, thorough initial surgery is critical. Further consideration needs to be given therefore to usage of SLNB in these high-risk patients.Table 1: Receptor status of patients with axillary pCR ER PositiveER negativeHER2 Positive53.8 % (7/13)83% (10/12)HER2 Negative25% (7/28)50% (8/16) p2analysis
Topic: Axilla
IntroductionManagement of the clinically positive axilla, down-staged to clinically negative by primary chemotherapy is controversial. The 2017 St Gallen consensus proposed sentinel lymph node biopsy (SLNB) alone, providing three negative sentinel nodes are identified, but this has not become standard practice. This study aims to identify factors associated with negative axillary lymph node histology in these patients.MethodRetrospective data was collected on breast cancer patients completing six cycles of primary chemotherapy, between 01/02/2014 and 31/01/2018. Patients were included if they were node positive on core biopsy histology prior to chemotherapy, down-staged to node negative on ultrasound, and underwent axillary lymph node dissection. ResultsOf 69 patients meeting the inclusion criteria, 46.3% (n=32) had pathological complete response (pCR) in the axilla. When complete radiological response in the breast occurred, 70.55% (12/17) of patients had axillary pCR, compared to 38.5% (20/52) where residual breast disease was seen radiologically (pConclusionThis study demonstrates that despite complete axillary radiological response following primary chemotherapy, over 50% of patients will have residual axillary disease. Patients with ER negative/HER2 positive disease had a significantly lower risk, however with limited further adjuvant treatment, thorough initial surgery is critical. Further consideration needs to be given therefore to usage of SLNB in these high-risk patients.Table 1: Receptor status of patients with axillary pCR ER PositiveER negativeHER2 Positive53.8 % (7/13)83% (10/12)HER2 Negative25% (7/28)50% (8/16) p2analysis
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