EBCC-11: Omission of Sentinel Lymph Node Biopsy in Subset of Patients With Breast Cancer
Posted: Monday, April 2, 2018
Two studies revealed that sentinel lymph node biopsy (SLNB) may not be necessary for some women if they present with clinically negative nodes at diagnosis and have a breast pathologic complete response (pCR) after neoadjuvant treatment. The findings of these studies were presented at the 11th European Breast Cancer Conference (EBBC-11) in Barcelona (Abstracts 104 and 20).
In the first study, Christian Sisó, MD, of the University Hospital Vall Hebron, Barcelona, and colleagues enrolled 90 patients with HER2-positive or triple-negative breast cancer and either clinically node-negative (cN0) or cN1 disease. Following neoadjuvant treatment in the cN0 group, 42.5% had breast pCR and 96.3% had no evidence of axillary node metastases. In the cN1 group, 76.5% women with breast pCR and 36.8% without breast pCR had no evidence of residual nodal disease.
“Patients with clinically negative axillary nodes who achieved a breast pCR are very unlikely to have positive axillary nodes and may be spared SLNB,” stated Dr. Sisó and colleagues. “However, in patients with cN1 [disease], the risk of leaving residual disease in the axilla, even in breast pCR, is not negligible."
The second study, led by Marieke van der Noordaa, MD, of the Netherlands Cancer Institute in Amsterdam, aimed to identify prognostic characteristics that may enable a patient to omit SLNB after neoadjuvant treatment. Their research, which included 298 patients with cN0 disease, found that 100% of women with HER-positive/hormone receptor–negative disease and 98.5% with triple-negative tumors (P < .001) had no axillary metastases following neoadjuvant treatment. The investigators concluded that clinicians may consider omitting SLNB after neoadjuvant treatment in this population.
