Clinical outcomes after sentinel lymph node biopsy in clinically node-negative breast cancer patients
Identifieur interne : 006C21 ( Ncbi/Merge ); précédent : 006C20; suivant : 006C22Clinical outcomes after sentinel lymph node biopsy in clinically node-negative breast cancer patients
Auteurs : Hee Ji Han [Corée du Sud] ; Ju Ree Kim [Corée du Sud] ; Hee Rim Nam [Corée du Sud] ; Ki Chang Keum [Corée du Sud] ; Chang Ok Suh [Corée du Sud] ; Yong Bae Kim [Corée du Sud]Source :
- Radiation Oncology Journal [ 2234-1900 ] ; 2014.
Abstract
To evaluate non-sentinel lymph node (LN) status after sentinel lymph node biopsy (SNB) in patients with breast cancer and to identify the predictive factors for disease failure.
From January 2006 to December 2007, axillary lymph node (ALN) dissection after SNB was performed for patients with primary invasive breast cancer who had no clinical evidence of LN metastasis. A total of 320 patients were treated with breast-conserving surgery and radiotherapy.
The median age of patients was 48 years, and the median follow-up time was 72.8 months. Close resection margin (RM) was observed in 13 patients. The median number of dissected SNB was two, and that of total retrieved ALNs was 11. Sentinel node accuracy was 94.7%, and the overall false negative rate (FNR) was 5.3%. Eleven patients experienced treatment failure. Local recurrence, regional LN recurrence, and distant metastasis were identified in 0.9%, 1.9%, and 2.8% of these patients, respectively. Sentinel LN status were not associated with locoregional recurrence (p > 0.05). Close RM was the only significant factor for disease-free survival (DFS) in univariate and multivariate analysis. The 5-year overall survival, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively.
In this study, SNB was performed with high accuracy and low FNR and high locoregional control was achieved.
Url:
DOI: 10.3857/roj.2014.32.3.132
PubMed: 25324984
PubMed Central: 4194295
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<series><title level="j">Radiation Oncology Journal</title>
<idno type="ISSN">2234-1900</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>Purpose</title>
<p>To evaluate non-sentinel lymph node (LN) status after sentinel lymph node biopsy (SNB) in patients with breast cancer and to identify the predictive factors for disease failure.</p>
</sec>
<sec><title>Materials and Methods</title>
<p>From January 2006 to December 2007, axillary lymph node (ALN) dissection after SNB was performed for patients with primary invasive breast cancer who had no clinical evidence of LN metastasis. A total of 320 patients were treated with breast-conserving surgery and radiotherapy.</p>
</sec>
<sec><title>Results</title>
<p>The median age of patients was 48 years, and the median follow-up time was 72.8 months. Close resection margin (RM) was observed in 13 patients. The median number of dissected SNB was two, and that of total retrieved ALNs was 11. Sentinel node accuracy was 94.7%, and the overall false negative rate (FNR) was 5.3%. Eleven patients experienced treatment failure. Local recurrence, regional LN recurrence, and distant metastasis were identified in 0.9%, 1.9%, and 2.8% of these patients, respectively. Sentinel LN status were not associated with locoregional recurrence (p > 0.05). Close RM was the only significant factor for disease-free survival (DFS) in univariate and multivariate analysis. The 5-year overall survival, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively.</p>
</sec>
<sec><title>Conclusion</title>
<p>In this study, SNB was performed with high accuracy and low FNR and high locoregional control was achieved.</p>
</sec>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Radiat Oncol J</journal-id>
<journal-id journal-id-type="iso-abbrev">Radiat Oncol J</journal-id>
<journal-id journal-id-type="publisher-id">ROJ</journal-id>
<journal-title-group><journal-title>Radiation Oncology Journal</journal-title>
</journal-title-group>
<issn pub-type="ppub">2234-1900</issn>
<issn pub-type="epub">2234-3164</issn>
<publisher><publisher-name>The Korean Society for Radiation Oncology</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25324984</article-id>
<article-id pub-id-type="pmc">4194295</article-id>
<article-id pub-id-type="doi">10.3857/roj.2014.32.3.132</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
<subj-group subj-group-type="heading"><subject>Clinical Investigations</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Clinical outcomes after sentinel lymph node biopsy in clinically node-negative breast cancer patients</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Han</surname>
<given-names>Hee Ji</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kim</surname>
<given-names>Ju Ree</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nam</surname>
<given-names>Hee Rim</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Keum</surname>
<given-names>Ki Chang</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Suh</surname>
<given-names>Chang Ok</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Kim</surname>
<given-names>Yong Bae</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.</aff>
<aff id="A2"><label>2</label>
Department of Radiation Oncology, Cheil General Hospital, Seoul, Korea.</aff>
<aff id="A3"><label>3</label>
Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.</aff>
<author-notes><corresp>Correspondence: Yong Bae Kim, MD, PhD, Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-749, Korea. Tel: +82-2-2228-8095, Fax: +82-2-2227-7823, <email>YBKIM3@yuhs.ac</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>9</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>30</day>
<month>9</month>
<year>2014</year>
</pub-date>
<volume>32</volume>
<issue>3</issue>
<fpage>132</fpage>
<lpage>137</lpage>
<history><date date-type="received"><day>21</day>
<month>4</month>
<year>2014</year>
</date>
<date date-type="rev-recd"><day>17</day>
<month>6</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>01</day>
<month>7</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2014. The Korean Society for Radiation Oncology</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec><title>Purpose</title>
<p>To evaluate non-sentinel lymph node (LN) status after sentinel lymph node biopsy (SNB) in patients with breast cancer and to identify the predictive factors for disease failure.</p>
</sec>
<sec><title>Materials and Methods</title>
<p>From January 2006 to December 2007, axillary lymph node (ALN) dissection after SNB was performed for patients with primary invasive breast cancer who had no clinical evidence of LN metastasis. A total of 320 patients were treated with breast-conserving surgery and radiotherapy.</p>
</sec>
<sec><title>Results</title>
<p>The median age of patients was 48 years, and the median follow-up time was 72.8 months. Close resection margin (RM) was observed in 13 patients. The median number of dissected SNB was two, and that of total retrieved ALNs was 11. Sentinel node accuracy was 94.7%, and the overall false negative rate (FNR) was 5.3%. Eleven patients experienced treatment failure. Local recurrence, regional LN recurrence, and distant metastasis were identified in 0.9%, 1.9%, and 2.8% of these patients, respectively. Sentinel LN status were not associated with locoregional recurrence (p > 0.05). Close RM was the only significant factor for disease-free survival (DFS) in univariate and multivariate analysis. The 5-year overall survival, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively.</p>
</sec>
<sec><title>Conclusion</title>
<p>In this study, SNB was performed with high accuracy and low FNR and high locoregional control was achieved.</p>
</sec>
</abstract>
<kwd-group><kwd>Breast neoplasms</kwd>
<kwd>Sentinel lymph node biopsy</kwd>
<kwd>Axillary lymph node dissection</kwd>
<kwd>Neoplasm recurrence</kwd>
<kwd>Local</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label>
<caption><p>Patterns of failure. Eleven patients developed treatment failure; local recurrence, regional lymph node recurrence, and distant metastasis were identified in three patients (0.9%), six (1.9%), and nine (2.8%), respectively.</p>
</caption>
<graphic xlink:href="roj-32-132-g001"></graphic>
</fig>
<fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label>
<caption><p>(A) Overall survival (OS), (B) disease-free survival (DFS), and (C) locoregional DFS among all patients. The 5-year OS, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively.</p>
</caption>
<graphic xlink:href="roj-32-132-g002"></graphic>
</fig>
<table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Patient characteristics</p>
</caption>
<graphic xlink:href="roj-32-132-i001"></graphic>
<table-wrap-foot><fn><p>AJCC, American Joint Committee on Cancer; HER2, human epidermal growth factor receptor 2; IDC, invasive ductal carcinoma.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Treatment characteristics</p>
</caption>
<graphic xlink:href="roj-32-132-i002"></graphic>
<table-wrap-foot><fn><p>Values are presented as median (range) or number (%).</p>
<p>SLN, sentinel lymph node; ALN, axillary lymph node; RM, resection margin.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T3" orientation="portrait" position="float"><label>Table 3</label>
<caption><p>FNR rate according to the number of dissected SLNs</p>
</caption>
<graphic xlink:href="roj-32-132-i003"></graphic>
<table-wrap-foot><fn><p>SLN, sentinel lymph node; TN, true negative; FN, false negative; TP, true positive; FNR, false negative rate.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T4" orientation="portrait" position="float"><label>Table 4</label>
<caption><p>Univariate and multivariate associations of prognostic factors with recurrence-free survival</p>
</caption>
<graphic xlink:href="roj-32-132-i004"></graphic>
<table-wrap-foot><fn><p>LN, lymph node; EIC, extensive intraductal component; RM, resection margin; HER2, human epidermal growth factor receptor 2.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list><country><li>Corée du Sud</li>
</country>
<region><li>Région capitale de Séoul</li>
</region>
<settlement><li>Séoul</li>
</settlement>
</list>
<tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Han, Hee Ji" sort="Han, Hee Ji" uniqKey="Han H" first="Hee Ji" last="Han">Hee Ji Han</name>
</region>
<name sortKey="Keum, Ki Chang" sort="Keum, Ki Chang" uniqKey="Keum K" first="Ki Chang" last="Keum">Ki Chang Keum</name>
<name sortKey="Kim, Ju Ree" sort="Kim, Ju Ree" uniqKey="Kim J" first="Ju Ree" last="Kim">Ju Ree Kim</name>
<name sortKey="Kim, Yong Bae" sort="Kim, Yong Bae" uniqKey="Kim Y" first="Yong Bae" last="Kim">Yong Bae Kim</name>
<name sortKey="Nam, Hee Rim" sort="Nam, Hee Rim" uniqKey="Nam H" first="Hee Rim" last="Nam">Hee Rim Nam</name>
<name sortKey="Suh, Chang Ok" sort="Suh, Chang Ok" uniqKey="Suh C" first="Chang Ok" last="Suh">Chang Ok Suh</name>
</country>
</tree>
</affiliations>
</record>
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