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Prediction of axillary pathologic response with breast pathologic complete response after neoadjuvant chemotherapy

Breast Cancer Research and Treatment volume 176, pages 591–596 (2019)Cite this article

Abstract

Purpose

Many breast cancer patients receive sentinel lymph node biopsy after neoadjuvant chemotherapy (NAC). We evaluated the axillary pathologic complete response (pCR) in relation to achievement of breast pCR.

Methods

We evaluated 1044 patients who were diagnosed with invasive breast cancer and were treated with NAC followed by curative surgery at the Samsung Medical Center between January 2008 and December 2016. The pathologic node-positive rates in breast pCR patients were compared for different breast cancer subtypes and clinical nodal stages.

Results

Axillary pCR was achieved in 51.9% of the patients after NAC. In this case, the axillary pCR was associated with a biologic subtype (P < 0.0001), initial clinical tumor stage (P < 0.0001), clinical nodal stage (P = 0.0071), and breast pCR (P < 0.0001). In particular, axillary pCR correlated more than 80% with breast pCR (87.1%) or clinical nodal stage N0 (81.0%). Patients with breast pCR had 96.4% axillary pCR in clinical nodal stage N0, 86.1% in N1, and 84.7% in N2/N3.

Conclusion

Our study may help to predict node-positive rates in patients with breast pCR after NAC according to clinical node stage. Patients with a high probability of achieving pCR might be suitable candidates for more minimal surgery.

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Author notes

  1. Hee Jun Choi and Jai Min Ryu equally contributed to this work.

Affiliations

  1. Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea

    Hee Jun Choi

  2. Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Samsung Medical Center Cancer Hospital, Sungkyunkwan University School of Medicine, 5th Floor Breast-Endocrine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea

    Jai Min Ryu, Isaac Kim, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Jeong Eon Lee & Se Kyung Lee

  3. Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Se Kyung Lee

Authors
  1. Hee Jun Choi
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  2. Jai Min Ryu
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  3. Isaac Kim
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Correspondence to Se Kyung Lee.

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Conflict of interest

The authors declare that they have no conflicts of interest to disclose in relation to the production of this study.

Ethical approval

This study adhered to ethical tenets of the Declaration of Helsinki and was approved by the Institutional Review Board of Samsung Medical Center, Seoul, Korea (IRB File No. 2017-09-051).

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The need for informed consent was waived because of the low risk posed by this investigation.

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Choi, H.J., Ryu, J.M., Kim, I. et al. Prediction of axillary pathologic response with breast pathologic complete response after neoadjuvant chemotherapy. Breast Cancer Res Treat 176, 591–596 (2019). https://doi.org/10.1007/s10549-019-05214-y

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  • DOI: https://doi.org/10.1007/s10549-019-05214-y

Keywords

  • Axillary pathologic complete response
  • Neoadjuvant chemotherapy