Level I axillary dissection in patients with breast cancer and
tumor-involved sentinel lymph node after NAC is not sufficient
for adequate nodal staging

J 2023

Level I axillary dissection in patients with breast cancer and tumor-involved sentinel lymph node after NAC is not sufficient for adequate nodal staging

ŽATECKÝ, Jan, Oldřich COUFAL, Miloš HOLÁNEK, Otakar KUBALA, Markéta KEPIČOVÁ et. al.

Basic information

Original name

Level I axillary dissection in patients with breast cancer and tumor-involved sentinel lymph node after NAC is not sufficient for adequate nodal staging

Authors

ŽATECKÝ, Jan (203 Czech Republic, guarantor, belonging to the institution), Oldřich COUFAL, Miloš HOLÁNEK, Otakar KUBALA, Markéta KEPIČOVÁ, Jiří GATĚK, Milan LERCH and Matúš PETEJA (203 Czech Republic, belonging to the institution)

Edition

Turkish Journal of Surgery, 2023, 2564-6850

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

Turkey

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

RIV identification code

RIV/47813059:19510/23:A0000464

Organization unit

Faculty of Public Policies in Opava

DOI

http://dx.doi.org/10.47717/turkjsurg.2023.5984

Keywords in English

Breast cancer; sentinel lymph node biopsy; neoadjuvant chemotherapy; axillary dissection; level I axillary dissection

Abstract

V originále

Objective: The purpose of the study was to investigate the oncological sufficiency of level I axillary dissection for adequate histological nodal staging (ypN) in patients with breast cancer and tumor-involved sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC). Material and Methods: A prospective multicentre pilot study took place from 01.01.2018 to 30.11.2020 in three mammary centres in the Czech Republic in patients with breast cancer after NAC (NCT03556397). Patients in the cohort with positive histological frozen section of SLN were indicated to separate axillary dissection of levels I and II. Results: Sixty-one patients with breast cancer after NAC were included in the study according to inclusion and exclusion criteria. Twelve patients with breast cancer and tumour involved SLN after NAC were further included in the analysis. Two (16.7%) patients had positive non-sentinel lymph nodes in level I only, one (8.3%) patient had positive lymph nodes in level II only, and seven (58.3%) patients had positive lymph nodes in both levels. Level I axillary dissection in a patient with tumour involved SLN after NAC would have resulted in understaging in five (41.7%) patients, mostly ypN1 instead of ypN2. Conclusion: According to our pilot result, level I axillary dissection is not sufficient in terms of adequate histological nodal staging in breast cancer patients after NAC, and level II axillary dissection should not be omitted.

Citovat

ŽATECKÝ, Jan, Oldřich COUFAL, Miloš HOLÁNEK, Otakar KUBALA, Markéta KEPIČOVÁ, Jiří GATĚK, Milan LERCH and Matúš PETEJA. Level I axillary dissection in patients with breast cancer and tumor-involved sentinel lymph node after NAC is not sufficient for adequate nodal staging. Turkish Journal of Surgery. 2023, vol. 39, No 1, p. 1-6. ISSN 2564-6850. Available from: https://dx.doi.org/10.47717/turkjsurg.2023.5984.

@article{67341,
   author = {Žatecký, Jan and Coufal, Oldřich and Holánek, Miloš and Kubala, Otakar and Kepičová, Markéta and Gatěk, Jiří and Lerch, Milan and Peteja, Matúš},
   article_number = {1},
   doi = {http://dx.doi.org/10.47717/turkjsurg.2023.5984},
   keywords = {Breast cancer; sentinel lymph node biopsy; neoadjuvant chemotherapy; axillary dissection; level I axillary dissection},
   language = {eng},
   issn = {2564-6850},
   journal = {Turkish Journal of Surgery},
   title = {Level I axillary dissection in patients with breast cancer and tumor-involved sentinel lymph node after NAC is not sufficient for adequate nodal staging},
   url = {https://turkjsurg.com/full-text/1889/eng},
   volume = {39},
   year = {2023}
}

TY  - JOUR
ID  - 67341
AU  - Žatecký, Jan - Coufal, Oldřich - Holánek, Miloš - Kubala, Otakar - Kepičová, Markéta - Gatěk, Jiří - Lerch, Milan - Peteja, Matúš
PY  - 2023
TI  - Level I axillary dissection in patients with breast cancer and tumor-involved sentinel lymph node after NAC is not sufficient for adequate nodal staging
JF  - Turkish Journal of Surgery
VL  - 39
IS  - 1
SP  - 1-6
EP  - 1-6
SN  - 25646850
KW  - Breast cancer
KW  - sentinel lymph node biopsy
KW  - neoadjuvant chemotherapy
KW  - axillary dissection
KW  - level I axillary dissection
UR  - https://turkjsurg.com/full-text/1889/eng
N2  - Objective: The purpose of the study was to investigate the oncological sufficiency of level I axillary dissection for adequate histological nodal staging (ypN) in patients with breast cancer and tumor-involved sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC). Material and Methods: A prospective multicentre pilot study took place from 01.01.2018 to 30.11.2020 in three mammary centres in the Czech Republic in patients with breast cancer after NAC (NCT03556397). Patients in the cohort with positive histological frozen section of SLN were indicated to separate axillary dissection of levels I and II. Results: Sixty-one patients with breast cancer after NAC were included in the study according to inclusion and exclusion criteria. Twelve patients with breast cancer and tumour involved SLN after NAC were further included in the analysis. Two (16.7%) patients had positive non-sentinel lymph nodes in level I only, one (8.3%) patient had positive lymph nodes in level II only, and seven (58.3%) patients had positive lymph nodes in both levels. Level I axillary dissection in a patient with tumour involved SLN after NAC would have resulted in understaging in five (41.7%) patients, mostly ypN1 instead of ypN2. Conclusion: According to our pilot result, level I axillary dissection is not sufficient in terms of adequate histological nodal staging in breast cancer patients after NAC, and level II axillary dissection should not be omitted.
ER  -

ŽATECKÝ, Jan, Oldřich COUFAL, Miloš HOLÁNEK, Otakar KUBALA, Markéta KEPIČOVÁ, Jiří GATĚK, Milan LERCH and Matúš PETEJA. Level I axillary dissection in patients with breast cancer and tumor-involved sentinel lymph node after NAC is not sufficient for adequate nodal staging. \textit{Turkish Journal of Surgery}. 2023, vol.~39, No~1, p.~1-6. ISSN~2564-6850. Available from: https://dx.doi.org/10.47717/turkjsurg.2023.5984.

Detailed Information on Publication Record