Evidence map›Paper›PMID 39282037›Full record

ArticleGland surgery2024

Omission of axillary surgery in cN0, postmenopausal ER-positive/HER2-negative breast cancer patients undergoing breast-conserving treatment.

Yeonjoo Kwon, Jihe Lim, Boram Ha, Sanghwa Kim, Jung Ho Park, Young Ah Lim, Hee-Joon Kang, Doyil Kim, Janghee Lee

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Article in Gland surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Yeonjoo Kwon *Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.
Jihe Lim *Department of Radiology, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.
Boram HaDepartment of Radiation Oncology, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.
Sanghwa KimDepartment of Surgery, Hallym University Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.
Jung Ho ParkDepartment of Surgery, Hallym University Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.
Young Ah LimDepartment of Surgery, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.
Hee-Joon KangDepartment of Surgery, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.
Doyil KimDepartment of Surgery, Hallym University Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.
Janghee LeeDepartment of Surgery, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si, Republic of Korea.ORCID https://orcid.org/0000-0003-1790-0788

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Previous clinical trials have diminished the significance of lymph node (LN) metastasis and axillary surgery in breast cancer, particularly in cN0, postmenopausal estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative patients undergoing breast-conserving treatment (BCT). We assessed the replacement of axillary surgery with preoperative imaging modalities by analyzing the proportion of high nodal burden (HNB) patients with ≥3 LN metastases in these patients. Methods: We retrospectively identified 333 cN0, postmenopausal ER-positive/HER2-negative breast cancer patients who underwent BCT in two hospitals between January 2003 and December 2017. The proportion of LN metastasis patients and the number of metastatic LN were investigated. Risk factors of LN metastasis were analyzed and recurrence-free survival (RFS) was compared. Results: Axillary surgery confirmed LN metastasis in 81 (24.3%) of the cN0 patients. The clinical tumor size (cT) and age were factors associated with LN metastasis [cT: odds ratio (OR), 2.92, 95% confidence interval (CI): 1.69-5.05, P<0.001; age: OR, 0.33, 95% CI: 0.11-0.99, P=0.048]. However, HNB patients with ≥3 LN metastases were 15 (4.5%) of all the patients. There was statistically significant difference in the incidence of HNB between patients with cT1 tumors (3.6%) and those with cT2 tumors (7.4%) (P<0.001). Conclusions: In cN0, postmenopausal ER-positive/HER2-negative patients who underwent BCT, patients with cT1 tumors had lower rate of LN metastasis, and there were fewer instances of HNB. Therefore, in these patients, omission of axillary surgery including SLNB can be carefully considered.

Indexed as

axillary surgerybreast-conserving treatment (BCT)Estrogen receptor-positive/human epidermal growth factor receptor 2-negative breast cancer (ER+/HER2− breast cancer)lymph node metastasispostmenopausal women

Identifiers

PMID39282037
PMCPMC11399007

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.