Breast Cancer Recurrence in Initially Clinically Node-Positive Patients Undergoing Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in the NEOSENTITURK-Trials MF18-02/18-03
Neslihan Cabioglu, Abdullah Igci, Mahmut Muslumanoglu, Mustafa Tukenmez, Selman Emiroglu, Halime Gul Kilic, Beyza Ozcinar, Vahit Ozmen, Hasan Karanlik, Suleyman Bademler, Berkay Kilic, Nilufer Yildirim, Mehmet Ali Gulcelik, Cihan Uras, Halil Kara, H. B. Kocer, Didem Can Trabulus, Enver Ozkurt, Serkan Ilgun, GK Çakmak, Ebru Sen, Kazim Senol, Israa Aljorani, Bulent Citgez, Banu Yigit, Elif Baran, Yeliz E. Ersoy, Ahmet Dag, Baha Zengel, Gul Basaran, Ece Dilege, Burak Celik, Orhan Agcaoglu, M. U. Ugurlu, Atilla Celik, Yasemin Bolukbasi, Niyazi Karaman, Lutfi Dogan, Guerhan Sakman, Ayfer Kamali Polat, Ibrahim Ali Ozemir, Ayse Altinok, Ecenur Varol, Zafer Utkan, Alper Akcan, Leyla Zer, Aykut Soyder, Mehmet Velidedeoglu, Fazilet Erozgen, Berk Goktepe, Mutlu Dogan, Abut Kebudi, Serdar Yormaz, Cumhur Arici, Ali Ibrahim Sevinc, M. Kemal Atahan, Vafa Valiyeva, Atilla Soran, Adnan Aydiner, Kamuran Ibis, Goekhan Giray Akgul, Serdar Ozbas, Levent Yeniay, Taner Kivilcim
article (Uluslararası, Hakemli) | Yazar(lar): Neslihan Cabioglu, Abdullah Igci, Mahmut Muslumanoglu, Mustafa Tukenmez, Selman Emiroglu, Halime Gul Kilic, Beyza Ozcinar, Vahit Ozmen, Hasan Karanlik, Suleyman Bademler, Berkay Kilic, Nilufer Yildirim, Mehmet Ali Gulcelik, Cihan Uras, Halil Kara, H. B. Kocer, Didem Can Tra
Background. This study aims to identify factors predicting recurrence and unfavorable prognosis in cN+ patients who have undergone sentinel lymph node biopsy (SLNB) following neoadjuvant chemotherapy (NAC). MethodsThe retrospective multi-centre "MF18-02" and the prospective multi-centre cohort registry trial "MF18-03" (NCT04250129) included patients with cT1-4N1-3M0 with SLNB+/- axillary lymph node dissection (ALND) post-NAC. Results. A total of 2407 cN+ patients, who later achieved cN0 status after NAC and subsequently underwent SLNB, were studied. The majority had cT1-2 (79.1%) and N1 (80.7%). After a median follow-up time of 41 months, the rates of locoregional recurrence and axillary recurrence (AR) were 1.83% and 0.37%, respectively. No significant difference in locoregional recurrence or AR rates was observed between the SLNB/targeted axillary dissection-only (n = 1470) and ALND (n = 937) groups. Factors significantly linked with AR included age younger than 45 years, nonpathological complete response (non-pCR) in the breast, and nonluminal pathology. Locoregional recurrences were associated with nonluminal or HER2(+) pathology, non-pCR in the breast, and ALND. Poor prognostic factors for disease-free survival (DFS) included having cT3-T4, no breast pCR (non-pCR), ypN(+), and nonluminal pathology. No significant difference was found in DFS or disease-specific survival (DSS) rates among ypN0, ypN-isolated tumour cells, ypNmic, and ypN1. However, significant decreases in DFS and DSS rates were observed when comparing ypN2 or ypN3 disease with ypN0. Conclusions. The present large registry data indicate that younger patients (<45), those with nonluminal pathology, and those who only partially respond in the breast are more susceptible to axillary and locoregional recurrences.