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Axillary lymph node count is lower after neoadjuvant chemotherapy.

Heather Neuman1, Lisa A Carey, David W Ollila

  • 1Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

American Journal of Surgery
|May 25, 2006
PubMed
Summary
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Neoadjuvant chemotherapy for breast cancer is linked to fewer lymph nodes retrieved during axillary dissection (ALND). This finding suggests a lower lymph node count may not indicate incomplete surgery after neoadjuvant treatment.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Fewer than 10 lymph nodes retrieved during axillary dissection (ALND) for breast cancer may indicate anatomical variation or incomplete surgery.
  • Neoadjuvant chemotherapy is increasingly used for breast cancer treatment.

Purpose of the Study:

  • To investigate the association between neoadjuvant chemotherapy and lymph node yield in ALND.
  • To determine if a lower lymph node count after neoadjuvant chemotherapy reflects inadequate surgical dissection.

Main Methods:

  • Retrospective comparison of patients undergoing neoadjuvant chemotherapy followed by ALND versus surgery-first patients.
  • All patients received level I and II ALND by experienced breast surgeons.
  • Lymph node counts were dichotomized (<10 vs. >=10) and compared using Fisher exact test.

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Main Results:

  • 143 neoadjuvant and 170 surgery-first patients were analyzed.
  • Patients receiving neoadjuvant chemotherapy had significantly higher rates of retrieving fewer than 10 lymph nodes (13% vs. 4%, P=.003).

Conclusions:

  • A low lymph node count (<10) is more frequent in breast cancer patients treated with neoadjuvant chemotherapy.
  • This finding should not be automatically interpreted as an incomplete axillary dissection.