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.
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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
Original language English
Type of outcome Article in a journal
Field of Study 30212 Surgery
Country of publisher Turkey
Confidentiality degree is not subject to a state or trade secret
WWW 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
Tags International impact, Reviewed
Changed by Changed by: Ing. Lucie Chmelařová, učo 50152. Changed: 25/3/2024 13:59.
Abstract
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.
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