Improved Axillary Evaluation Following Neoadjuvant Therapy for Patients With Node-Positive Breast Cancer Using Selective Evaluation of Clipped Nodes: Implementation of Targeted Axillary Dissection

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Abigail S CaudleHenry M Kuerer

Abstract

Placing clips in nodes with biopsy-confirmed metastasis before initiating neoadjuvant therapy allows for evaluation of response in breast cancer. Our goal was to determine if pathologic changes in clipped nodes reflect the status of the nodal basin and if targeted axillary dissection (TAD), which includes sentinel lymph node dissection (SLND) and selective localization and removal of clipped nodes, improves the false-negative rate (FNR) compared with SLND alone. A prospective study of patients with biopsy-confirmed nodal metastases with a clip placed in the sampled node was performed. After neoadjuvant therapy, patients underwent axillary surgery and the pathology of the clipped node was compared with other nodes. Patients undergoing TAD had SLND and selective removal of the clipped node using iodine-125 seed localization. The FNR was determined in patients undergoing complete axillary lymphadenectomy (ALND). Of 208 patients enrolled in this study, 191 underwent ALND, with residual disease identified in 120 (63%). The clipped node revealed metastases in 115 patients, resulting in an FNR of 4.2% (95% CI, 1.4 to 9.5) for the clipped node. In patients undergoing SLND and ALND (n = 118), the FNR was 10.1% (95% CI, 4.2 to 19.8), whi...Continue Reading

References

Apr 20, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Eleftherios P MamounasNorman Wolmark
Dec 20, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Bryan T HennessyVicente Valero
May 9, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Anthony LucciUNKNOWN American College of Surgeons Oncology Group
Dec 31, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jean-Marc ClasseSylvia Giard
Oct 9, 2013·JAMA : the Journal of the American Medical Association·Judy C BougheyUNKNOWN Alliance for Clinical Trials in Oncology
Dec 3, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jean-Francois BoileauAndre Robidoux

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Citations

Jan 18, 2016·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·I T Rubio
Jul 2, 2016·Annals of Surgical Oncology·Henry M Kuerer, Raquel F D van la Parra
Jul 2, 2016·Annals of Surgical Oncology·Beyhan Ataseven, Gunter von Minckwitz
Oct 14, 2016·The Lancet Oncology·Ismail JatoiMasakazu Toi
Oct 12, 2016·AJR. American Journal of Roentgenology·Kyungmin ShinWei Yang
Jan 31, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·W Fraser SymmansGabriel N Hortobagyi
Jun 18, 2017·Nanomedicine·Muneer AhmedMichael Douek
May 2, 2018·Future Oncology·Giovanni CorsoViviana Galimberti
Nov 15, 2017·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·A KarakatsanisF Wärnberg
Sep 19, 2017·ANZ Journal of Surgery·Annelise M CoccoElisabeth Elder
Jan 24, 2019·Journal of Clinical Pathology·Miralem MrkonjicAnna Marie Mulligan
Jun 27, 2019·Journal of Surgical Oncology·Stephen F Sener
Jul 16, 2019·Expert Opinion on Drug Safety·Sherif Hassanien Ahmed
Oct 31, 2019·Current Oncology Reports·Ángel MonteroPhilip Poortmans
Nov 2, 2019·AJR. American Journal of Roentgenology·Sadia Choudhery
Jun 1, 2017·American Society of Clinical Oncology Educational Book·Henry M KuererRobert W Mutter
Dec 14, 2019·Current Opinion in Obstetrics & Gynecology·Nina DitschThorsten Kuehn
Dec 27, 2019·The Breast Journal·David M Euhus
Nov 20, 2019·Breast Cancer Research and Treatment·Laura H RosenbergerJennifer K Plichta

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