RT Journal Article
SR Electronic
T1 Nomogram Predicting Axillary Lymph Node Dissection Omission After Neoadjuvant Chemotherapy for Node-positive Breast Cancer
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 5131
OP 5138
DO 10.21873/anticanres.17338
VO 44
IS 11
A1 SEKI, HIROHITO
A1 ISHIGURO, YUKI
A1 MAKINO, AKITSUGU
A1 YAMAGUCHI, KEI
A1 IMOTO, SHIGERU
YR 2024
UL http://ar.iiarjournals.org/content/44/11/5131.abstract
AB Background/Aim: To develop an accurate method to predict nodal pathological complete response (ypN0) in patients after neoadjuvant chemotherapy (NAC) for clinically node-positive breast cancer. Patients and Methods: We included 128 patients with clinically node-positive primary breast cancer who underwent axillary lymph node dissection after NAC. Results: Breast primary tumor clinical complete response (ycT0) was observed in 29.7% and nodal clinical complete response (ycN0) in 44.5% of cases. When ycN0 was predicted as ypN0, the negative predictive value was 77.2%, and the false-negative rate was 19.7%. Estrogen receptor status, ycT0, and ycN0 were independent predictive factors for ypN0 after NAC in patients with clinically node-positive breast cancer. These factors were used to develop a nomogram for ypN0 prediction. The following points were added: 82 in case of estrogen receptor-negative, 56 in case of ycT0, and 100 in case of ycN0. Score summation was used to prognosticate the manifestation of ypN0. Our nomogram predicted ypN0 with a negative predictive value of 92.9% and false-negative rate of 4.5%, demonstrating an approximate 15% improvement over ypN0 prediction using ycN0 alone. Conclusion: Estrogen receptor-negativity, ycT0, and ycN0 are independent predictive factors for ypN0 after NAC in clinically node-positive breast cancer. The nomogram may improve individualized axillary treatment.