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Open Access 01-12-2019 | Ultrasound | Research

Higher axillary lymph node metastasis burden in breast cancer patients with positive preoperative node biopsy: may not be appropriate to receive sentinel lymph node biopsy in the post-ACOSOG Z0011 trial era

Authors: Yue Liang, Xiaosong Chen, Yiwei Tong, Weiwei Zhan, Ying Zhu, Jiayi Wu, Ou Huang, Jianrong He, Li Zhu, Yafen Li, Weiguo Chen, Kunwei Shen

Published in: World Journal of Surgical Oncology | Issue 1/2019

Abstract

Background

Breast cancer patients with suspicious axillary lymph node (ALN) at ultrasound and positive fine-needle aspiration (FNA) results were required to receive ALN dissection (ALND), which was not certain in the post-ACOSOG Z0011 era. We aim to evaluate the ALN metastasis burden in these patients, thus to illustrate whether they can follow the ACOSOG Z0011 trial procedure.

Methods

Clinically, T1–2 N0 breast cancer patients with positive preoperative ALN biopsy (FNA group) or 1–2 positive sentinel nodes (SLNB group) were retrospectively analyzed. ALN metastasis burden was compared between the two groups, which were further analyzed in certain subtypes. An association between clinicopathological factors and ≥ 3 ALN metastasis was also analyzed.

Results

A total of 388 patients were included: 202 in the FNA group and 186 in the SLNB group. The FNA group had a significantly higher number of positive ALN (5.18 vs. 1.77, P < 0.001) and a larger proportion of patients with ≥ 3 ALN metastasis (58.42% vs. 11.83%, P < 0.001) than the SLNB group, which was not influenced by different tumor size stage and molecular subtypes. ALN metastasis identified by FNA was independently associated with a high rate of ≥ 3 ALN metastasis (OR = 6.98, 95% CI 1.95–25.02, P = 0.003).

Conclusions

Patients with positive preoperative ALN biopsy had a higher ALN metastasis burden than patients with 1–2 positive SLNs, which was also the strongest factor associated with ≥ 3 ALN metastasis, indicating that these patients are not appropriate to receive SLNB in the post-ACOSOG Z0011 trial era.

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Title: Higher axillary lymph node metastasis burden in breast cancer patients with positive preoperative node biopsy: may not be appropriate to receive sentinel lymph node biopsy in the post-ACOSOG Z0011 trial era
Authors: Yue Liang
Xiaosong Chen
Yiwei Tong
Weiwei Zhan
Ying Zhu
Jiayi Wu
Ou Huang
Jianrong He
Li Zhu
Yafen Li
Weiguo Chen
Kunwei Shen
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Ultrasound
Metastasis
Breast Cancer
Foreign Body Aspiration
Foreign Body Aspiration
Aspiration
Breast Cancer
Ultrasound
Published in: World Journal of Surgical Oncology / Issue 1/2019
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-019-1582-z

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Higher axillary lymph node metastasis burden in breast cancer patients with positive preoperative node biopsy: may not be appropriate to receive sentinel lymph node biopsy in the post-ACOSOG Z0011 trial era

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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