Background:
The association of clinical/pathological parameters and residual axillary involvement
after NACT is still not sufficiently defined. We used data from the SENTINA trial
to analyze this association in a patient population with limited sentinel lymph node
(SLN) involvement.
Methods:
Patients were included if before NACT they presented with a clinically negative axilla
but showed involvement of < 3 SLNs prior to NACT (Arm B). The association between
clinical/pathological parameters and axillary involvement after NACT was analyzed.
Results:
265 of the 360 patients in arm B of the SENTINA were included. After NACT 66/265 (24.9%)
patients had involved SLNs or non-SLNs; 71/265 (26.8%) achieved a pCR in the breast.
We observed a significant association between pCR in the breast and ER negativity
(p < 0.0001), PR negativity (p < 0.0001) and triple negative (TN) status (p = 0.001).
However, no statistically significant association between residual axillary involvement
after NACT and ER (p = 0.381), PR (p = 0.52), HER2 (p = 0.771), TN status (p = 0.937),
grade (G) 1 (p = 0.081), G 2 (p = 0.335), G 3 (p = 0.747), age (p = 0.789), tumor
size before NACT (p = 0.761) and pCR in the breast (p = 0.136) could be demonstrated.
Conclusion:
We found no association between residual axillary involvement after NACT and clinical/pathological
parameters and we could not identify a subset of patients for whom axillary treatment
after NACT could be safely omitted if SLNs were positive prior to therapy even in
cases of limited SLN involvement.
