Abstract
Background: According to the current guidelines, residual axillary lymph node involvement after neoadjuvant systemic therapy (NST) is the most determining factor for postmastectomy radiation therapy (PMRT). If immediate breast reconstruction is performed after mastectomy, PMRT can adversely affect the reconstructed breast. Preoperative identification of patients who do need PMRT is essential to enable adequate shared decision-making when choosing the optimal timing of breast reconstruction. The aim of this study was to determine the risk of a positive sentinel lymph node (SLN) after NST in clinically node negative (cN0) breast cancer patients.
Highlights
Residual axillary lymph node involvement after neoadjuvant systemic therapy (NST) is the determining factor for postmastectomy radiation therapy (PMRT)
Multivariable regression analysis showed that cT2, cT3, grade 3, and ER?HER2- subtype were correlated with positive sentinel lymph node (SLN)
A total of 1914 patients were diagnosed with cT1-3N0 breast cancer between January 2010 and December 2016 in the Netherlands and treated with NST followed by mastectomy and sentinel lymph node biopsy (SLNB)
Summary
Residual axillary lymph node involvement after neoadjuvant systemic therapy (NST) is the determining factor for postmastectomy radiation therapy (PMRT). Preoperative identification of patients needing PMRT is essential to enable shared decision-making when choosing the optimal timing of breast reconstruction. We determined the risk of positive sentinel lymph node (SLN) after NST in clinically node-negative (cN0) breast cancer. All cT1-3N0 patients treated with NST followed by mastectomy and SLNB between 2010 and 2016 were identified from the Netherlands Cancer Registry. Rate of positive SLN for different breast cancer subtypes was determined. Logistic regression analysis was performed to determine correlated clinicopathological variables with positive SLN
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