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Evaluating Axillary Lymph Node Yield After Neoadjuvant Chemotherapy.

Betty Fan1, Kelsey Romatoski2, Jaime Pardo2

  • 1Breast Surgery, Department of Surgical Oncology, Indiana University Health, Indiana University School of Medicine, Indianapolis, IN, USA.

Annals of Surgical Oncology
|August 26, 2022
PubMed
Summary
This summary is machine-generated.

Neoadjuvant chemotherapy (NAC) does not impact lymph node yield (LNY) after axillary lymph node dissection (ALND) in breast cancer patients. This finding is crucial for accurate axillary staging, regardless of NAC treatment.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Neoadjuvant chemotherapy (NAC) is a recognized treatment for breast cancer.
  • The impact of NAC on axillary lymph node yield (LNY) after axillary lymph node dissection (ALND) is not well-established.
  • Accurate axillary staging is critical for breast cancer patient management.

Purpose of the Study:

  • To investigate the effect of neoadjuvant chemotherapy (NAC) on lymph node yield (LNY) following axillary lymph node dissection (ALND).
  • To determine if NAC influences the number of lymph nodes removed during ALND for breast cancer staging.

Main Methods:

  • Retrospective analysis of the National Cancer Database (2010-2015).
  • Inclusion of breast cancer patients (T0-T4, N0-3, M0) who underwent ALND.
  • Comparison of LNY between patients receiving NAC versus primary surgery (PS) using univariate analysis.

Main Results:

  • Study included 118,108 breast cancer patients; 24.6% received NAC.
  • Median LNY was 11 in both the NAC group (Q1, Q3: 6, 16) and the PS group (Q1, Q3: 6, 17).
  • Statistical analysis showed no significant difference in LNY between the groups (p < 0.001).

Conclusions:

  • Neoadjuvant chemotherapy (NAC) does not significantly alter lymph node yield (LNY) following axillary lymph node dissection (ALND).
  • Equivalent LNY should be pursued regardless of whether patients receive NAC.
  • Findings support consistent axillary staging practices for breast cancer patients.