In Which Luminal Breast Cancers Might Neoadjuvant Chemotherapy Be Appropriate to Achieve a Pathological Complete Response in Axillary Lymph Nodes?
Eda Tanrikulu Simsek1, Ezgi Coban1, Elif Alag1, Murat Sari1, Gunay Gurleyik21Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey, 2Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
Objectives: In this study, we aimed to evaluate in which luminal/human epidermal growth factor receptor 2 negative (her2-) breast cancers (BCs) would be achieved complete pathological response in axillary lymph nodes with neoadjuvant chemotherapy (ypN0). Methods: We retrospectively analyzed 66 patients with luminal/her2- BC who were operated after neoadjuvant chemotherapy (NAC). We evaluated the predictive factors for ypN0 after NAC. Results: We detected ypT0 in 15.2% of the patients and ypN0 in 31.8%. Univariate analysis indicated that grade, cN stage, and anatomical stage were significant predictors of ypN0. According to the multivariate analysis, grade was the only significant factor in predicting ypN0 independently of other factors (p=0.037). Considering the grades of cN1 patients, the ypN0 rate was 2/18 (11.1%) for grade 1-2 and 7/10 (70%) for grade 3 (p=0.01). Conclusion: In the presence of cN1 axillary lymph nodes, the decision of NAC can be challenging for clinicians in luminal BC patients, especially with no clear indication for NAC. Nowadays, if ycN0 is provided after NAC in cN1 cases, methods such as sentinel lymph node dissection/targeted axillary dissection are more commonly used for axillary staging. Based on the findings of our study, we think it would be appropriate to use NAC in patients with luminal BC with the goal of reducing axillary surgery in the presence of cN1, grade 3 tumors. Keywords: breast cancer, chemotherapy, axilla, luminal
Cite This Article
Simsek E, Coban E, Alag E, Sari M, Gurleyik G. In Which Luminal Breast Cancers Might Neoadjuvant Chemotherapy Be Appropriate to Achieve a Pathological Complete Response in Axillary Lymph Nodes?. EJMI. 2022; 6(2): 184-189
Corresponding Author: Eda Tanrikulu Simsek