Axillary management after Neoadjuvant Chemotherapy in node positive breast cancer.
Association of Breast Surgery ePoster Library. McKenna A. 05/13/19; 257068; P024
Adrian McKenna
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Abstract
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P024
Topic: Axilla
Introduction: The surgical
management of the axilla in patients who are undergoing neoadjuvant
chemotherapy (NAC) remains unclear. There is little consensus on how best to
proceed in patients with low volume axillary disease who have radiological evidence
of response to treatment.Aims: Our aim was to identify patients
who can safely avoid axillary clearance in low volume nodal disease after NAC. Methods : A retrospective single Centre analysis of 95 consecutive
breast cancer patients (Jan. 2012 to Dec. 2016) who were assessed as being node
positive at diagnosis and who received NAC was performed. Patient demographics,
radiological assessment of response to therapy, and final histopathological
data were analysed. Results: Response to NAC by clinical & radiological assessment = 95No. PtsFinal nodal StatusNode Negative ITC/Micromet1-3 LNS +ve (N1)>3 LNs +veNo tumour response + No LN response71 (14.3%)1 (14.3%)5(71.4%)Partial tumour response + No /partial LN response4824 (50%)16 (33.3%)8(16.7%)Partial tumour response + complete LN response98 (88.9%)1 (11.1%)0Complete tumour response + incomplete LN response95 (55.6%)2 (22.2%)2 (22.2%)Complete tumour response + complete LN response1212 (100%)00Inflammatory carcinoma6303Conclusion: In patients who
had evidence of partial radiological axillary/tumour response, 49% of these had
persistent nodal disease, therefore necessitating complete axillary dissection.
However, those patients with evidence of complete radiological response after
NAC were all node negative, suggesting that these patients can safely avoid
axillary clearance.
Topic: Axilla
Introduction: The surgical
management of the axilla in patients who are undergoing neoadjuvant
chemotherapy (NAC) remains unclear. There is little consensus on how best to
proceed in patients with low volume axillary disease who have radiological evidence
of response to treatment.Aims: Our aim was to identify patients
who can safely avoid axillary clearance in low volume nodal disease after NAC. Methods : A retrospective single Centre analysis of 95 consecutive
breast cancer patients (Jan. 2012 to Dec. 2016) who were assessed as being node
positive at diagnosis and who received NAC was performed. Patient demographics,
radiological assessment of response to therapy, and final histopathological
data were analysed. Results: Response to NAC by clinical & radiological assessment = 95No. PtsFinal nodal StatusNode Negative ITC/Micromet1-3 LNS +ve (N1)>3 LNs +veNo tumour response + No LN response71 (14.3%)1 (14.3%)5(71.4%)Partial tumour response + No /partial LN response4824 (50%)16 (33.3%)8(16.7%)Partial tumour response + complete LN response98 (88.9%)1 (11.1%)0Complete tumour response + incomplete LN response95 (55.6%)2 (22.2%)2 (22.2%)Complete tumour response + complete LN response1212 (100%)00Inflammatory carcinoma6303Conclusion: In patients who
had evidence of partial radiological axillary/tumour response, 49% of these had
persistent nodal disease, therefore necessitating complete axillary dissection.
However, those patients with evidence of complete radiological response after
NAC were all node negative, suggesting that these patients can safely avoid
axillary clearance.
P024
Topic: Axilla
Introduction: The surgical
management of the axilla in patients who are undergoing neoadjuvant
chemotherapy (NAC) remains unclear. There is little consensus on how best to
proceed in patients with low volume axillary disease who have radiological evidence
of response to treatment.Aims: Our aim was to identify patients
who can safely avoid axillary clearance in low volume nodal disease after NAC. Methods : A retrospective single Centre analysis of 95 consecutive
breast cancer patients (Jan. 2012 to Dec. 2016) who were assessed as being node
positive at diagnosis and who received NAC was performed. Patient demographics,
radiological assessment of response to therapy, and final histopathological
data were analysed. Results: Response to NAC by clinical & radiological assessment = 95No. PtsFinal nodal StatusNode Negative ITC/Micromet1-3 LNS +ve (N1)>3 LNs +veNo tumour response + No LN response71 (14.3%)1 (14.3%)5(71.4%)Partial tumour response + No /partial LN response4824 (50%)16 (33.3%)8(16.7%)Partial tumour response + complete LN response98 (88.9%)1 (11.1%)0Complete tumour response + incomplete LN response95 (55.6%)2 (22.2%)2 (22.2%)Complete tumour response + complete LN response1212 (100%)00Inflammatory carcinoma6303Conclusion: In patients who
had evidence of partial radiological axillary/tumour response, 49% of these had
persistent nodal disease, therefore necessitating complete axillary dissection.
However, those patients with evidence of complete radiological response after
NAC were all node negative, suggesting that these patients can safely avoid
axillary clearance.
Topic: Axilla
Introduction: The surgical
management of the axilla in patients who are undergoing neoadjuvant
chemotherapy (NAC) remains unclear. There is little consensus on how best to
proceed in patients with low volume axillary disease who have radiological evidence
of response to treatment.Aims: Our aim was to identify patients
who can safely avoid axillary clearance in low volume nodal disease after NAC. Methods : A retrospective single Centre analysis of 95 consecutive
breast cancer patients (Jan. 2012 to Dec. 2016) who were assessed as being node
positive at diagnosis and who received NAC was performed. Patient demographics,
radiological assessment of response to therapy, and final histopathological
data were analysed. Results: Response to NAC by clinical & radiological assessment = 95No. PtsFinal nodal StatusNode Negative ITC/Micromet1-3 LNS +ve (N1)>3 LNs +veNo tumour response + No LN response71 (14.3%)1 (14.3%)5(71.4%)Partial tumour response + No /partial LN response4824 (50%)16 (33.3%)8(16.7%)Partial tumour response + complete LN response98 (88.9%)1 (11.1%)0Complete tumour response + incomplete LN response95 (55.6%)2 (22.2%)2 (22.2%)Complete tumour response + complete LN response1212 (100%)00Inflammatory carcinoma6303Conclusion: In patients who
had evidence of partial radiological axillary/tumour response, 49% of these had
persistent nodal disease, therefore necessitating complete axillary dissection.
However, those patients with evidence of complete radiological response after
NAC were all node negative, suggesting that these patients can safely avoid
axillary clearance.
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