• Je něco špatně v tomto záznamu ?

Axillary Overtreatment in Patients with Breast Cancer After Neoadjuvant Chemotherapy in the Current Era of Targeted Axillary Dissection

O. Zapletal, J. Žatecký, L. Gabrielová, I. Selingerová, M. Holánek, P. Burkoň, O. Coufal

. 2025 ; 17 (2) : . [pub] 20250108

Status neindexováno Jazyk angličtina Země Švýcarsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc25008690

Grantová podpora
MMCI, 00209805 MH CZ - DRO
long-term institutional support for research activities Faculty of Public Policy, Silesian University in Opava

BACKGROUND: In the current era of targeted axillary dissection (TAD), there are still cases where axillary lymph node dissection (ALND) is indicated, but histopathological examination confirms the regression of nodal metastases (ypN0). In this situation, ALND may represent undesirable overtreatment. METHODS: A retrospective study at the Comprehensive Cancer Centre was conducted based on a prospectively maintained database. Patients who underwent surgery after neoadjuvant chemotherapy (NAC) between 2020 and 2023 were selected, specifically those for whom ALND was directly indicated after NAC. Subsequently, clinical-pathological characteristics were compared between cases with ypN0 and those with persistent metastases (ypN+). The reasons for indicating ALND in ypN0 cases were extracted from the medical records. RESULTS: ALND was indicated in 118 cases across 117 patients, of which ypN0 was observed in 44 cases (37%). There were significantly more ypN0 cases for inflammatory carcinomas (68%), the non-luminal HER2-positive phenotype (76%), and carcinomas with histopathological regression of the primary tumor (76%) or the persistence of only the non-invasive component of ypTis (67%). Typical reasons for ALND in ypN0 cases included inflammatory carcinoma (n = 13, 29.5%), locally advanced carcinoma (n = 5, 11.4%), occult carcinoma (n = 2, 4.5%), or persistent lymphadenopathy on ultrasound examination after NAC, especially in the tumor phenotypes HER2-positive and triple-negative breast cancer (TNBC) (n = 8, 18.2%). CONCLUSIONS: Through real-world evidence data analysis, subgroups of breast cancer patients treated with NAC were identified who may experience surgical overtreatment in the axilla. These include patients with inflammatory carcinoma, locally advanced carcinoma, occult carcinoma, or patients with persistent lymphadenopathy on US examination after NAC, particularly in the tumor phenotypes HER2-positive and TNBC.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc25008690
003      
CZ-PrNML
005      
20250422095636.0
007      
ta
008      
250408s2025 sz f 000 0|eng||
009      
AR
024    7_
$a 10.3390/cancers17020178 $2 doi
035    __
$a (PubMed)39857960
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a sz
100    1_
$a Zapletal, Ondřej $u Department of Surgical Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic $u Department of Surgical Oncology, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
245    10
$a Axillary Overtreatment in Patients with Breast Cancer After Neoadjuvant Chemotherapy in the Current Era of Targeted Axillary Dissection / $c O. Zapletal, J. Žatecký, L. Gabrielová, I. Selingerová, M. Holánek, P. Burkoň, O. Coufal
520    9_
$a BACKGROUND: In the current era of targeted axillary dissection (TAD), there are still cases where axillary lymph node dissection (ALND) is indicated, but histopathological examination confirms the regression of nodal metastases (ypN0). In this situation, ALND may represent undesirable overtreatment. METHODS: A retrospective study at the Comprehensive Cancer Centre was conducted based on a prospectively maintained database. Patients who underwent surgery after neoadjuvant chemotherapy (NAC) between 2020 and 2023 were selected, specifically those for whom ALND was directly indicated after NAC. Subsequently, clinical-pathological characteristics were compared between cases with ypN0 and those with persistent metastases (ypN+). The reasons for indicating ALND in ypN0 cases were extracted from the medical records. RESULTS: ALND was indicated in 118 cases across 117 patients, of which ypN0 was observed in 44 cases (37%). There were significantly more ypN0 cases for inflammatory carcinomas (68%), the non-luminal HER2-positive phenotype (76%), and carcinomas with histopathological regression of the primary tumor (76%) or the persistence of only the non-invasive component of ypTis (67%). Typical reasons for ALND in ypN0 cases included inflammatory carcinoma (n = 13, 29.5%), locally advanced carcinoma (n = 5, 11.4%), occult carcinoma (n = 2, 4.5%), or persistent lymphadenopathy on ultrasound examination after NAC, especially in the tumor phenotypes HER2-positive and triple-negative breast cancer (TNBC) (n = 8, 18.2%). CONCLUSIONS: Through real-world evidence data analysis, subgroups of breast cancer patients treated with NAC were identified who may experience surgical overtreatment in the axilla. These include patients with inflammatory carcinoma, locally advanced carcinoma, occult carcinoma, or patients with persistent lymphadenopathy on US examination after NAC, particularly in the tumor phenotypes HER2-positive and TNBC.
590    __
$a NEINDEXOVÁNO
655    _2
$a časopisecké články $7 D016428
700    1_
$a Žatecký, Jan $u Department of Surgical Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic $u Department of Surgery, Silesian Hospital in Opava, 746 01 Opava, Czech Republic $u The Institute of Paramedical Health Studies, Faculty of Public Policies, Silesian University, 746 01 Opava, Czech Republic $1 https://orcid.org/0000000204150853
700    1_
$a Gabrielová, Lucie $u Department of Surgical Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic $u Department of Surgical Oncology, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
700    1_
$a Selingerová, Iveta $u Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic $u Department of Pharmacology, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic $1 https://orcid.org/0000000337133504
700    1_
$a Holánek, Miloš $u Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic $u Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic $1 https://orcid.org/0000000312261593
700    1_
$a Burkoň, Petr $u Department of Radiation Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic $u Department of Radiation Oncology, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic $1 https://orcid.org/0000000298639376
700    1_
$a Coufal, Oldřich $u Department of Surgical Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic $u Department of Surgical Oncology, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic $1 https://orcid.org/0000000286008606
773    0_
$w MED00173178 $t Cancers $x 2072-6694 $g Roč. 17, č. 2 (2025)
856    41
$u https://pubmed.ncbi.nlm.nih.gov/39857960 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20250408 $b ABA008
991    __
$a 20250422095638 $b ABA008
999    __
$a ok $b bmc $g 2306455 $s 1245765
BAS    __
$a 3
BAS    __
$a PreBMC-PubMed-not-MEDLINE
BMC    __
$a 2025 $b 17 $c 2 $e 20250108 $i 2072-6694 $m Cancers $n Cancers (Basel) $x MED00173178
GRA    __
$a MMCI, 00209805 $p MH CZ - DRO
GRA    __
$a long-term institutional support for research activities $p Faculty of Public Policy, Silesian University in Opava
LZP    __
$a Pubmed-20250408

Najít záznam

Citační ukazatele

Možnosti archivace