Advanced SearchSearch Tips
Effect of Neoadjuvant Chemotherapy on Axillary Lymph Node Positivity and Numbers in Breast Cancer Cases
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
 Title & Authors
Effect of Neoadjuvant Chemotherapy on Axillary Lymph Node Positivity and Numbers in Breast Cancer Cases
Uyan, Mikail; Koca, Bulent; Yuruker, Savas; Ozen, Necati;
  PDF(new window)
Background: The aim of this study is to compare the numbers of axillary lymph nodes (ALN) taken out by dissection between patients with breast cancer operated on after having neoadjuvant chemotherapy (NAC) treatment and otherswithout having neoadjuvant chemotherapy, and to investigate factors affecting lymph node positivity. Materials and Methods: A total of 49 patients operated due to advanced breast cancer after neoadjuvant chemotherapy and 144 patients with a similar stage of the cancer having primary surgical treatment without chemotherapy at the general surgery clinic of Ondokuz Mayis University Medicine Faculty between the dates 01.01.2006 and 31.10.2012 were included in the study. The total number of lymph nodes taken out by axillary dissection (ALND) was categorized as the number of positive lymph nodes and divided into <10 and . The variables to be compared were analysed using the program SPSS 15.0 with P<0.05 accepted as significant. Results: Median number of dissected lymph nodes from the patient group having neoadjuvant chemotherapy was 16 (16-33) while it was 20 (5-55) without chemotherapy. The respective median numbers of positive lymph nodes were 5 (0-19) and 10 (0-51). In 8 out of 49 neoadjuvant chemotherapy patients (16.3%), the number of dissected lymph nodes was below 10, and it was below 10 in 17 out of 144 primary surgery patients. Differences in numbers of dissected total and positive lymph nodes between two groups were significant, but this was not the case for numbers of <10 lymph nodes. Conclusions: The number of dissected lymph nodes from the patients with breast cancer having neoadjuvant chemotherapy may be less than without chemotherapy. This may not always be attributed to an inadequate axillary dissection. More research to evaluate the numbers of positive lymph nodes are required in order to increase the reliability of staging in the patients with breast cancer undergoing neoadjuvant chemotherapy.
Breast cancer;neoadjuvant chemotherapy;axillary lymph nodes;dissection;
 Cited by
Apffelstaedt JP (2003). Locally advanced breast cancer in developing countries: the place of surgery. World J Surg, 27, 917-20. crossref(new window)

Belanger J, Soucy G, Sideris L, et al (2008). Neoadjuvant chemotherapy in invasive breast cancer results in a lower axillary lymph node count. J Am Coll Surg, 206, 704-8. crossref(new window)

Boughey JC, Mc Call LM, Ballman KV, et al (2014). Tumor biology correlates with rates of breast-conserving surgery and pathologic complete response after neoadjuvant chemotherapy for breast cancer: findings from the ACOSOG Z1071 (Alliance) Prospective Multicenter Clinical Trial. Ann Surg, 260. 608-14 crossref(new window)

Brotherick I, Shenton BK, CoWan WK, et al (1995). The relationship between flow-cytometric and immunohistochemically detected c-erbB2 expression, grade and DNA ploidy in breast cancer. Cancer Immunol Immunother, 41, 137-45. crossref(new window)

Chaves-Mac Gregor M, Gonzalez-Angulo AM, (2010). Breast cancer, neoadjuvant chemotherapy and residual disease. Clin Trans Oncol, 12, 461-7. crossref(new window)

Clark GM, McGuire WL (1988). Steroid receptors and other prognostic factors in primary breast cancer. Semin Oncol, 15-20.

Colleoni M, Minchella I, Mazzarol G, et al (2000). Response to primary chemotherapy in breast cancer patients with tumours not expressing estrogen and progesterone receptors. Ann Oncol, 11, 1057-9. crossref(new window)

Giani C, Campani D, De Negri F, et al (1989). Relationship between progesterone receptor, axillary node status and productive fibrosis in ductal infiltrating carcinoma of the breast. Appl Pathol, 7, 225-32.

Goel S, Chirgwin J, Francis P, et al (2011). Rational use of transtuzumab in metastatic and locally advanced breast cancer; implications of recent research. Breast, 20, 101-10. crossref(new window)

Gogia A, Raina V, Deo SV, et al (2014). Taxane and anthracycline based neoadjuvant chemotherapy for locally advanced breast cancer: institutional experience. Asian Pac J Cancer Prev, 15, 1989-92. crossref(new window)

Greene FL, Page DL, Fleming ID (2002). AJCC Cancer Staging Manual, 6th Edition, New York,Springer-Verlag, 227-8.

Keam B, Im SA, Lim Y, et al (2013). Clinical usefulness of AJCC response criteria for neoadjuvant chemotherapy in breast cancer. Ann Surg Oncol, 11, 435-41.

Khokher S, Mahmood S, Khan SA (2010). Response to neoadjuvant chemotherapy in patients with advanced breast cancer: a local hospital experience. Asian Pac J Cancer Prev, 11, 303-8.

Knight WA, Livinston RB, Gregory FJ, et al (1977). Estrogen receptor as an independent prognostic factor for early reccurence in breast cancer. Cancer Res, 37, 46-69.

Kuerer HM, Newman LA, Buzdar AU, et al (1998). Pathologic tumor responce in breast following neoadjuvant chemotherapypredicts axillarylymph node status. Cancer J Sci Am, 4, 230-6.

Kurio K, Toi M, Tsuda H, et al (2006). Issues in the assessment of the pathologic effect of primary systemic therapy for breast cancer. Breast Cancer, 13, 38-48. crossref(new window)

Makris A, Powles TJ, Dowsett M, et al (1997).Prediction of response to neoadjuvant chemoendocrine therapy in primary breast carcinomas. Clin Cancer Res, 3, 593-600.

Neuman H, Carey LA, Ollila DW, et al (2006). Axillary lymph node count is lower after neoadjuvant chemotherapy. Am J Surg, 191, 827-9. crossref(new window)

Rahusen FD, Torrenga H, van Diest PJ, et al (2001). Predictive factors for metastatic involvement of nonsentinel nodes in patients with breast cancer. Arch Surg, 136, 1059-63. crossref(new window)

Schaapveld M, Otter R, De Vries EG et al (2004). Variability in axillary lymph node dissection for breast cancer. J Surg Oncol, 87, 4-12. crossref(new window)

Somner JE, Dixon JM, Thomas JS (2004). Node retrival in axillary lymph node dissection: recommendations for minimum numbers to be confident about node negative status. J Clin Pathol, 57, 845-8. crossref(new window)

Thain SK, Olivotto IA, Bouchard F, et al (1998). Axillary dissection.The steering committee on clinical practice guidilines for the care and treatment of breast cancer. Can Med Assoc J, 10. 158.

Yu Y, Xiang H, He XM, et al (2013). Predictive factors determining neoadjuvant chemotherapy outcomes in breast cancer - a single center experience. Asian Pac J Cancer Prev, 14, 2401-6. crossref(new window)