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Axillary Reverse Mapping in Clinically Node-Positive Breast Cancer Patients.
Masakuni Noguchi1, Masafumi Inokuchi1, Miki Yokoi-Noguchi1
1Breast Center, Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Daigaku-1-1, Uchinada, Kahoku 920-0293, Ishikawa, Japan.
Cancers
|November 14, 2023
Summary
Neoadjuvant chemotherapy (NAC) significantly reduces axillary reverse mapping (ARM) node metastasis in clinically node-positive breast cancer patients. However, 18F-FDG-PET/CT imaging is not reliable for detecting residual axillary disease post-NAC.
Area of Science:
- Oncology
- Surgical Oncology
- Nuclear Medicine
Background:
- Axillary reverse mapping (ARM) nodes are frequently involved in clinically node-positive (cN+) breast cancer.
- Neoadjuvant chemotherapy (NAC) effectively reduces nodal metastases in cN+ patients.
Purpose of the Study:
- To evaluate the impact of NAC on ARM node involvement in cN+ breast cancer patients.
- To assess the utility of 18F-FDG-PET/CT in detecting residual axillary disease after NAC.
Main Methods:
- 145 cN+ patients with confirmed nodal involvement underwent either upfront axillary lymph node dissection (ALND) or ALND after NAC.
- Patients underwent 18F-FDG-PET/CT before surgery and an ARM procedure during ALND.
Main Results:
- ARM node involvement was significantly lower in the NAC group (36.6%) compared to the upfront surgery group (62.2%).
- NAC decreased involvement in non-luminal tumors (18.4%) more than luminal tumors (48.5%).
- 18F-FDG-PET/CT findings did not reliably predict residual ARM node involvement post-NAC.
Conclusions:
- NAC significantly reduces the risk of ARM node metastasis in cN+ breast cancer.
- 18F-FDG-PET/CT is not suitable for detecting residual metastatic disease in the axilla after NAC.
