Predictors of Non-Sentinel Node Metastasis and Poorer Patient Response to Neoadjuvant Chemotherapy in Primary Breast Cancer: A 10-Year Study
Association of Breast Surgery ePoster Library. Jenkins S. 05/13/19; 257080; P036
Sam Jenkins
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P036
Topic: Breast surgery
Introduction: The ability to predict non-sentinel node (non-SLN) metastasis in breast cancer patients has been an area of intense research for the past decade. This study aimed to identify predictors of non-SLN metastasis and level 3 node involvement. Further objectives included identifying factors which predicted poorer patient response to neoadjuvant chemotherapy (NAC). Methods :Electronic patient records of 1088 patients who underwent ANC between 2007-2016 at the Royal Hallamshire Hospital, Sheffield, UK were reviewed. Clinicopathological characteristics were used to identify factors predicting lymph node metastasis. RESULTS: Larger tumour size (OR=1.025; CI=1.016-1.034; p<0.001), grade 3 (OR=3.706; CI=2.102-6.534) and grade 2 tumours (OR=2.174; CI=1.245-3.795) compared to grade 1 tumours (p<0.001), presence of lymphovascular invasion (LVI) (OR=2.832; CI=2.064-3.885; p<0.001), ER-negative tumours (OR=2.339; CI=1.472-3.717; p<0.001), and number of positive SLNs (OR=1.756; CI=1.333-2.313; p<0.001) were all significantly associated with non-SLN metastasis. In addition to these characteristics, lobular carcinomas (OR=1.832; CI=1.157-2.899; p=0.034) and multifocal tumours (OR=1.717; CI=1.108-2.662; p=0.016) were also significantly associated with level 3 disease. In patients who underwent NAC, larger tumour size (OR=1.040; CI=1.025-1.056; p<0.001), presence of LVI (OR=3.030; CI=1.673-5.488; p=0.001), and HER2-negative tumours (OR=1.983; CI=1.177-3.343; p=0.01) significantly predicted non-SLN metastasis, despite treatment. These same variables significantly predicted level 3 metastasis.CONCLUSION:Based on the significant associations identified,multivariate analysis and development of an accurate model of predicting non-SLN metastasis will allow patients to make a more informed decision as to whether they wish to proceed with full ANC, participate in a clinical trial, or choose to have their axilla re-staged following neoadjuvant chemotherapy.
Topic: Breast surgery
Introduction: The ability to predict non-sentinel node (non-SLN) metastasis in breast cancer patients has been an area of intense research for the past decade. This study aimed to identify predictors of non-SLN metastasis and level 3 node involvement. Further objectives included identifying factors which predicted poorer patient response to neoadjuvant chemotherapy (NAC). Methods :Electronic patient records of 1088 patients who underwent ANC between 2007-2016 at the Royal Hallamshire Hospital, Sheffield, UK were reviewed. Clinicopathological characteristics were used to identify factors predicting lymph node metastasis. RESULTS: Larger tumour size (OR=1.025; CI=1.016-1.034; p<0.001), grade 3 (OR=3.706; CI=2.102-6.534) and grade 2 tumours (OR=2.174; CI=1.245-3.795) compared to grade 1 tumours (p<0.001), presence of lymphovascular invasion (LVI) (OR=2.832; CI=2.064-3.885; p<0.001), ER-negative tumours (OR=2.339; CI=1.472-3.717; p<0.001), and number of positive SLNs (OR=1.756; CI=1.333-2.313; p<0.001) were all significantly associated with non-SLN metastasis. In addition to these characteristics, lobular carcinomas (OR=1.832; CI=1.157-2.899; p=0.034) and multifocal tumours (OR=1.717; CI=1.108-2.662; p=0.016) were also significantly associated with level 3 disease. In patients who underwent NAC, larger tumour size (OR=1.040; CI=1.025-1.056; p<0.001), presence of LVI (OR=3.030; CI=1.673-5.488; p=0.001), and HER2-negative tumours (OR=1.983; CI=1.177-3.343; p=0.01) significantly predicted non-SLN metastasis, despite treatment. These same variables significantly predicted level 3 metastasis.CONCLUSION:Based on the significant associations identified,multivariate analysis and development of an accurate model of predicting non-SLN metastasis will allow patients to make a more informed decision as to whether they wish to proceed with full ANC, participate in a clinical trial, or choose to have their axilla re-staged following neoadjuvant chemotherapy.
P036
Topic: Breast surgery
Introduction: The ability to predict non-sentinel node (non-SLN) metastasis in breast cancer patients has been an area of intense research for the past decade. This study aimed to identify predictors of non-SLN metastasis and level 3 node involvement. Further objectives included identifying factors which predicted poorer patient response to neoadjuvant chemotherapy (NAC). Methods :Electronic patient records of 1088 patients who underwent ANC between 2007-2016 at the Royal Hallamshire Hospital, Sheffield, UK were reviewed. Clinicopathological characteristics were used to identify factors predicting lymph node metastasis. RESULTS: Larger tumour size (OR=1.025; CI=1.016-1.034; p<0.001), grade 3 (OR=3.706; CI=2.102-6.534) and grade 2 tumours (OR=2.174; CI=1.245-3.795) compared to grade 1 tumours (p<0.001), presence of lymphovascular invasion (LVI) (OR=2.832; CI=2.064-3.885; p<0.001), ER-negative tumours (OR=2.339; CI=1.472-3.717; p<0.001), and number of positive SLNs (OR=1.756; CI=1.333-2.313; p<0.001) were all significantly associated with non-SLN metastasis. In addition to these characteristics, lobular carcinomas (OR=1.832; CI=1.157-2.899; p=0.034) and multifocal tumours (OR=1.717; CI=1.108-2.662; p=0.016) were also significantly associated with level 3 disease. In patients who underwent NAC, larger tumour size (OR=1.040; CI=1.025-1.056; p<0.001), presence of LVI (OR=3.030; CI=1.673-5.488; p=0.001), and HER2-negative tumours (OR=1.983; CI=1.177-3.343; p=0.01) significantly predicted non-SLN metastasis, despite treatment. These same variables significantly predicted level 3 metastasis.CONCLUSION:Based on the significant associations identified,multivariate analysis and development of an accurate model of predicting non-SLN metastasis will allow patients to make a more informed decision as to whether they wish to proceed with full ANC, participate in a clinical trial, or choose to have their axilla re-staged following neoadjuvant chemotherapy.
Topic: Breast surgery
Introduction: The ability to predict non-sentinel node (non-SLN) metastasis in breast cancer patients has been an area of intense research for the past decade. This study aimed to identify predictors of non-SLN metastasis and level 3 node involvement. Further objectives included identifying factors which predicted poorer patient response to neoadjuvant chemotherapy (NAC). Methods :Electronic patient records of 1088 patients who underwent ANC between 2007-2016 at the Royal Hallamshire Hospital, Sheffield, UK were reviewed. Clinicopathological characteristics were used to identify factors predicting lymph node metastasis. RESULTS: Larger tumour size (OR=1.025; CI=1.016-1.034; p<0.001), grade 3 (OR=3.706; CI=2.102-6.534) and grade 2 tumours (OR=2.174; CI=1.245-3.795) compared to grade 1 tumours (p<0.001), presence of lymphovascular invasion (LVI) (OR=2.832; CI=2.064-3.885; p<0.001), ER-negative tumours (OR=2.339; CI=1.472-3.717; p<0.001), and number of positive SLNs (OR=1.756; CI=1.333-2.313; p<0.001) were all significantly associated with non-SLN metastasis. In addition to these characteristics, lobular carcinomas (OR=1.832; CI=1.157-2.899; p=0.034) and multifocal tumours (OR=1.717; CI=1.108-2.662; p=0.016) were also significantly associated with level 3 disease. In patients who underwent NAC, larger tumour size (OR=1.040; CI=1.025-1.056; p<0.001), presence of LVI (OR=3.030; CI=1.673-5.488; p=0.001), and HER2-negative tumours (OR=1.983; CI=1.177-3.343; p=0.01) significantly predicted non-SLN metastasis, despite treatment. These same variables significantly predicted level 3 metastasis.CONCLUSION:Based on the significant associations identified,multivariate analysis and development of an accurate model of predicting non-SLN metastasis will allow patients to make a more informed decision as to whether they wish to proceed with full ANC, participate in a clinical trial, or choose to have their axilla re-staged following neoadjuvant chemotherapy.
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