Oncologic outcomes of de-escalating axillary treatment in clinically node-positive breast cancer patients treated with neoadjuvant systemic therapy - A two center cohort study.
Robert-Jan SchipperAnne de BruijnMaurice J C van der SangenJohanne G BloemenIngrid van den HovenEster E M SchepersBirgit E P VriensThom BoermanDorien C RijkaartLinda M H van de WinkelChristel BrouwerLaurence J C van WarmerdamMaaike P M GielensRob M G van BommelYvonne E van RietAdri C VoogdGrard A P NieuwenhuijzenPublished in: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (2024)
A total of 199 patients were included. Axillary pathological complete response was reported in 66 (33.2 %). Based on the treatment protocol and initial clinical staging, no adjuvant axillary treatment was indicated in 30 patients (15 %), while 139 (70 %) received axillary radiotherapy without performance of an axillary lymph node dissection (ALND). The remaining 30 patients (15 %) underwent an ALND with additional locoregional radiotherapy. A median follow-up of 62 months (30-106) showed that 4 (2 %) patients experienced an axillary recurrence after 7, 8, 36 and 36 months, respectively. In all 4 patients, synchronous distant metastases were diagnosed. The estimated 5-year aRFI was 97.8 % (95%-CI 95.6-99.9 %) CONCLUSION: Although longer follow-up should be awaited before final conclusions can be drawn regarding the oncological safety of this approach, the implementation of a de-escalating axillary treatment protocol appears to be safe since the estimated 5-year aRFI is 97.8 %.
Keyphrases
- lymph node
- end stage renal disease
- ejection fraction
- newly diagnosed
- neoadjuvant chemotherapy
- sentinel lymph node
- prognostic factors
- randomized controlled trial
- early stage
- stem cells
- squamous cell carcinoma
- primary care
- radiation therapy
- rectal cancer
- mesenchymal stem cells
- positive breast cancer
- combination therapy
- weight loss
- cell therapy
- free survival
- radical prostatectomy