Is axillary clearance needed for all node-positive patients who are having neoadjuvant chemotherapy?
Association of Breast Surgery ePoster Library. Al-Ishaq Z. 05/13/19; 257067; P023
Mr. Zaid Al-Ishaq
REGULAR CONTENT
Login now to access Regular content available to all registered users.
Abstract
Discussion Forum (0)
Rate & Comment (0)
P023
Topic: Axilla
INTRODUCTION:Controversy exists regarding ideal axillary staging procedure for node-positive patients who have neoadjuvant chemotherapy (NAC). For one abnormal lymph node (LN) and positive core biopsy, we offer sentinel node biopsy (SLNB) as an option if ultrasound scan (USS) showed good radiological response of LN and main tumour following NAC. Patients with multiple positive LN on core biopsy are offered axillary node clearance (ANC).AIM:To investigate what proportion of patients developed nodal pathological complete response (PathCR) after SLNB and ANC and identify factors that could predict nodal PathCR. Methods :Ninety-four consecutive NAC patients from October 2014 to January 2018 were studied. RESULTS: 66% (62/94) had positive nodes on core biopsy pre-NAC. 15(24%) patients had SLNB, of which 73 %( 11/15) developed nodal PathCR. 47(76%) patients had ANC, 40 %( 19/47) had nodal PathCR and 60 %( 28/47) remained node-positive. Looking at Her2 positivity and Path CR in these 47 ANC patients, 19 were Her 2 positive and 68 %( 13/19) showed nodal PathCR. 28 patients were Her2 negative and only 21 %( 6/28) had nodal PathCR. This was statistically significant (p value<0.002, Fisher's exact test, Two-tailed). 8/13(61%) Her2 positive and nodal PathCR patients showed good nodal radiological response in their post-NAC US scan.CONCLUSION:Patients with one abnormal node and good radiological response after NAC and those with more than one abnormal node but are Her2 positive and good radiological response on US scan will have nodal PathCR in 73% and 68% respectively. SLNB can be considered in these patients.
Topic: Axilla
INTRODUCTION:Controversy exists regarding ideal axillary staging procedure for node-positive patients who have neoadjuvant chemotherapy (NAC). For one abnormal lymph node (LN) and positive core biopsy, we offer sentinel node biopsy (SLNB) as an option if ultrasound scan (USS) showed good radiological response of LN and main tumour following NAC. Patients with multiple positive LN on core biopsy are offered axillary node clearance (ANC).AIM:To investigate what proportion of patients developed nodal pathological complete response (PathCR) after SLNB and ANC and identify factors that could predict nodal PathCR. Methods :Ninety-four consecutive NAC patients from October 2014 to January 2018 were studied. RESULTS: 66% (62/94) had positive nodes on core biopsy pre-NAC. 15(24%) patients had SLNB, of which 73 %( 11/15) developed nodal PathCR. 47(76%) patients had ANC, 40 %( 19/47) had nodal PathCR and 60 %( 28/47) remained node-positive. Looking at Her2 positivity and Path CR in these 47 ANC patients, 19 were Her 2 positive and 68 %( 13/19) showed nodal PathCR. 28 patients were Her2 negative and only 21 %( 6/28) had nodal PathCR. This was statistically significant (p value<0.002, Fisher's exact test, Two-tailed). 8/13(61%) Her2 positive and nodal PathCR patients showed good nodal radiological response in their post-NAC US scan.CONCLUSION:Patients with one abnormal node and good radiological response after NAC and those with more than one abnormal node but are Her2 positive and good radiological response on US scan will have nodal PathCR in 73% and 68% respectively. SLNB can be considered in these patients.
P023
Topic: Axilla
INTRODUCTION:Controversy exists regarding ideal axillary staging procedure for node-positive patients who have neoadjuvant chemotherapy (NAC). For one abnormal lymph node (LN) and positive core biopsy, we offer sentinel node biopsy (SLNB) as an option if ultrasound scan (USS) showed good radiological response of LN and main tumour following NAC. Patients with multiple positive LN on core biopsy are offered axillary node clearance (ANC).AIM:To investigate what proportion of patients developed nodal pathological complete response (PathCR) after SLNB and ANC and identify factors that could predict nodal PathCR. Methods :Ninety-four consecutive NAC patients from October 2014 to January 2018 were studied. RESULTS: 66% (62/94) had positive nodes on core biopsy pre-NAC. 15(24%) patients had SLNB, of which 73 %( 11/15) developed nodal PathCR. 47(76%) patients had ANC, 40 %( 19/47) had nodal PathCR and 60 %( 28/47) remained node-positive. Looking at Her2 positivity and Path CR in these 47 ANC patients, 19 were Her 2 positive and 68 %( 13/19) showed nodal PathCR. 28 patients were Her2 negative and only 21 %( 6/28) had nodal PathCR. This was statistically significant (p value<0.002, Fisher's exact test, Two-tailed). 8/13(61%) Her2 positive and nodal PathCR patients showed good nodal radiological response in their post-NAC US scan.CONCLUSION:Patients with one abnormal node and good radiological response after NAC and those with more than one abnormal node but are Her2 positive and good radiological response on US scan will have nodal PathCR in 73% and 68% respectively. SLNB can be considered in these patients.
Topic: Axilla
INTRODUCTION:Controversy exists regarding ideal axillary staging procedure for node-positive patients who have neoadjuvant chemotherapy (NAC). For one abnormal lymph node (LN) and positive core biopsy, we offer sentinel node biopsy (SLNB) as an option if ultrasound scan (USS) showed good radiological response of LN and main tumour following NAC. Patients with multiple positive LN on core biopsy are offered axillary node clearance (ANC).AIM:To investigate what proportion of patients developed nodal pathological complete response (PathCR) after SLNB and ANC and identify factors that could predict nodal PathCR. Methods :Ninety-four consecutive NAC patients from October 2014 to January 2018 were studied. RESULTS: 66% (62/94) had positive nodes on core biopsy pre-NAC. 15(24%) patients had SLNB, of which 73 %( 11/15) developed nodal PathCR. 47(76%) patients had ANC, 40 %( 19/47) had nodal PathCR and 60 %( 28/47) remained node-positive. Looking at Her2 positivity and Path CR in these 47 ANC patients, 19 were Her 2 positive and 68 %( 13/19) showed nodal PathCR. 28 patients were Her2 negative and only 21 %( 6/28) had nodal PathCR. This was statistically significant (p value<0.002, Fisher's exact test, Two-tailed). 8/13(61%) Her2 positive and nodal PathCR patients showed good nodal radiological response in their post-NAC US scan.CONCLUSION:Patients with one abnormal node and good radiological response after NAC and those with more than one abnormal node but are Her2 positive and good radiological response on US scan will have nodal PathCR in 73% and 68% respectively. SLNB can be considered in these patients.
Code of conduct/disclaimer available in General Terms & Conditions
{{ help_message }}
{{filter}}