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Tytuł:
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The prognostic impact of mode of detection of axillary metastases for women with invasive breast cancer: A retrospective observational study.
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Autorzy:
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McNeil K; Clinical Radiology, Ninewells Hospital and Medical School, Dundee, Scotland, DD1 9SY, UK; NHS Tayside, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK; University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK. Electronic address: .
Macaskill EJ; Department of Breast Surgery, Ninewells Hospital and Medical School, Dundee, Scotland, DD1 9SY, UK; NHS Tayside, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK; University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK. Electronic address: .
Purdie C; Department of Pathology, Ninewells Hospital and Medical School, Dundee, Scotland, DD1 9SY, UK; NHS Tayside, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK; University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK. Electronic address: .
Evans A; Department of Breast Imaging, Ninewells Hospital and Medical School, Dundee, Scotland, DD1 9SY, UK; NHS Tayside, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK; University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK. Electronic address: .
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Źródło:
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European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2021 Apr; Vol. 47 (4), pp. 813-817. Date of Electronic Publication: 2020 Nov 01.
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Typ publikacji:
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Journal Article; Observational Study
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Język:
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English
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Imprint Name(s):
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Publication: : Amsterdam : Elsevier
Original Publication: London ; New York : Academic Press, [1985-
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MeSH Terms:
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Biopsy, Large-Core Needle*
Sentinel Lymph Node Biopsy*
Breast Neoplasms/*pathology
Breast Neoplasms/*therapy
Sentinel Lymph Node/*pathology
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use ; Axilla ; Breast Neoplasms/diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Image-Guided Biopsy ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Grading ; Preoperative Period ; Prognosis ; Retrospective Studies ; Sentinel Lymph Node/diagnostic imaging ; Survival Rate ; Tumor Burden ; Ultrasonography ; Young Adult
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Contributed Indexing:
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Keywords: Axilla; Breast cancer; Core biopsy; Mortality; Sentinel node; Ultrasound
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Substance Nomenclature:
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0 (Antineoplastic Agents)
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Entry Date(s):
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Date Created: 20201106 Date Completed: 20210927 Latest Revision: 20210927
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Update Code:
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20240105
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DOI:
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10.1016/j.ejso.2020.10.035
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PMID:
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33153822
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Aim: To identify the breast cancer specific survival (BCSS) associated with nodal metastasis identified by axillary core biopsy (ACB), and by sentinel node biopsy (SNB) compared with node negative patients. A further aim was to assess the prognostic effects of axillary ultrasound (US) features and amount of tumour in ACB specimens.
Methods: Consecutive patients with cancer were identified from a database of US lesions undergoing breast biopsy. The three study groups were: a) those with metastasis identified by ACB, b) those undergoing immediate surgery with positive SNB and c) those undergoing immediate surgery with a negative SNB. US features and the amount of tumour in the ACB specimen were assessed by review of US images and pathological reports. BCSS was assessed using Kaplan Meier survival curves.
Results: 967 patients were included, with mean follow-up of 6.0 yrs. There were 90 breast cancer deaths: 26% of those with a positive ACB, 11% with a positive SNB and 4% of those with a negative SNB. BCSS was significantly different between the groups (p < 0.001) with hazard ratio, compared with the negative SNB group, of 7.8 (95% CI 4.4-13.7) for patients with positive ACB and 2.5 (95% CI 1.3-4.6) for positive SNB. Axillary US findings and assessment of the amount of tumour in the ACB did not influence survival.
Conclusion: This study suggests that women with a positive ACB have a worse BCSS compared to those with a positive SNB. This should be borne in mind when systemic therapy is being considered.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)
