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Histologic Grade and Decrease in Tumor Dimensions Affect Axillary Lymph Node Status after Neoadjuvant Chemotherapy in

Tae Hee Kim1, Doo Kyoung Kang1, Ji Young Kim2

  • 1Department of Radiology, Ajou University School of Medicine, Suwon, Korea.

Journal of Breast Cancer
|January 16, 2016
PubMed
Summary
This summary is machine-generated.

High histologic grade and significant tumor shrinkage (over 80%) predict successful axillary lymph node (ALN) downstaging after neoadjuvant chemotherapy (NAC) in breast cancer patients. This finding aids in predicting treatment response.

Keywords:
Axillary lymph nodeBreast neoplasmsMagnetic resonance imagingNeoadjuvant chemotherapy

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Area of Science:

  • Oncology
  • Radiology
  • Pathology

Background:

  • Neoadjuvant chemotherapy (NAC) is a standard treatment for breast cancer.
  • Assessing axillary lymph node (ALN) status after NAC is crucial for treatment planning.
  • Histologic factors and tumor response to NAC can influence ALN outcomes.

Purpose of the Study:

  • To identify histologic factors associated with negative conversion of axillary lymph nodes (ALN) after neoadjuvant chemotherapy (NAC).
  • To evaluate the relationship between primary breast tumor size reduction and ALN response to NAC.

Main Methods:

  • Retrospective analysis of 133 breast cancer patients who received NAC and had confirmed ALN metastases.
  • Pre- and post-NAC magnetic resonance imaging (MRI) to measure primary tumor dimensions.
  • Statistical analysis including univariate and multivariate logistic regression to identify predictive factors.

Main Results:

  • 29% of patients achieved negative ALN conversion post-NAC.
  • Multivariate analysis identified a significant decrease in primary tumor longest dimension (OR, 1.026) and high histologic grade (OR, 3.964) as independent predictors of ALN negative conversion.
  • A >80% decrease in tumor size combined with high histologic grade demonstrated 64% sensitivity and 92% specificity for predicting ALN response.

Conclusions:

  • High histologic grade and substantial primary tumor size reduction (>80%) are significantly associated with negative ALN conversion after NAC.
  • These factors can help predict the effectiveness of NAC in reducing axillary lymph node burden.