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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2018

01-12-2018 | ASO Author Reflections

ASO Author Reflections: Reducing Axillary Lymph Node Dissections in Node-Positive Breast Cancer Patients

Authors: Marieke E. M. van der Noordaa, MD, Marie-Jeanne T. F. D. Vrancken Peeters, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2018

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Excerpt

Improvements in neoadjuvant systemic therapy (NST) for breast cancer patients have led to increasing rates of pathologic complete response (pCR), allowing for less-extensive surgery of the breast and axillary lymph nodes (ALNs). Despite current pCR rates as high as 80% in patients with HER2+/hormone receptor-negative tumors,1 ALN dissections (ALNDs) are still frequently performed in clinically node positive (cN+) patients, leading to unnecessary comorbidity. One of the challenges that interferes with the potential to de-escalate axillary management is the continuing lack of consensus on the optimal axillary staging method in cN+ patients post-NST. Whereas post-NST sentinel lymph node biopsy (SLNB) can be safely performed in cN0 patients, SLNB is associated with high false-negative rates (FNRs) in cN+ patients.2 In addition, trials analyzing axillary staging after NST mainly focus on cN1 patients, while pCR rates in cN2–3 patients are also high. Omitting ALND in these patients could greatly reduce comorbidity since radiotherapy is indicated regardless of response in these patients. …
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Metadata
Title
ASO Author Reflections: Reducing Axillary Lymph Node Dissections in Node-Positive Breast Cancer Patients
Authors
Marieke E. M. van der Noordaa, MD
Marie-Jeanne T. F. D. Vrancken Peeters, MD, PhD
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6975-7

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