Senologie - Zeitschrift für Mammadiagnostik und -therapie 2018; 15(02): e34-e35
DOI: 10.1055/s-0038-1651768
Abstracts
Georg Thieme Verlag KG Stuttgart · New York

Accuracy of surgical opinion case report forms to predict type of axillary surgery after neoadjuvant chemotherapy in the AGO-35 trial

, , Arbeitsgemeinschaft Gynäkologische Onkologie Österreich
M Nanda
1   Abt. für Frauenheilkunde, LKH Leoben, Leoben, Österreich
,
F Peintinger
1   Abt. für Frauenheilkunde, LKH Leoben, Leoben, Österreich
2   Institut für Pathologie, Med. Univ. Graz, Graz, Österreich
,
E Sieghartsleitner
2   Institut für Pathologie, Med. Univ. Graz, Graz, Österreich
,
F Klaassen
3   Univ. Klinik für spezielle Gynäkologie, Paracelsus Medizinischen Privatuniversität, Salzburg, Österreich
,
R Reitsamer
3   Univ. Klinik für spezielle Gynäkologie, Paracelsus Medizinischen Privatuniversität, Salzburg, Österreich
,
HC Kolberg
4   Klinik für Gynäkologie und Geburtshilfe, Marienhospital, Bottrop, Deutschland
,
S Schmatloch
5   Brustzentrum am Elisabeth Krankenhaus, Kassel, Deutschland
,
T Kühn
6   Klinik für Frauenheilkunde und Geburtshilfe, Esslingen, Deutschland
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
22. Mai 2018 (online)

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    Purpose:

    To evaluate the accuracy of surgeon's opinion to predict axillary dissection (AND) or sentinel node biopsy (SLN) after neoadjuvant chemotherapy (NAC).

    Methods:

    The prospective AGO-35 trial examines the validation of a genomic test to predict tumor response in the axilla. As part of the trial we used surgical opinion case report forms to predict the type of final axillary surgery based on clinicopathological and radiologic parameters in HER2 negative breast cancer patients. All patients received anthracycline- and taxane based neoadjuvant chemotherapy. Tumor stage was determined by the participating surgeons before NAC (t1) and prior to surgery (t2). We analyzed the agreement between predicted axillary surgery and pathological complete response (pCR).

    Results:

    Of 205 patients, 161 complete surgical opinion case report forms were analyzed. Tumor stage ≥T2 at t1 was observed in 76% and nodal stage N≥1 in 57%. At final pathology 25% of the patients had a pCR in both the breast and axilla, 30% in the breast. 101 patients (63%) had a pCR in the axilla. Surgeons predicted a complete clinical response in the axillary nodes in 61/101 patients (60%). SLN as final axillary surgery was performed in 60/101 (59%). AND was performed in 41% of the patients who had a complete tumor response in the axilla.

    Conclusion:

    Surgical opinion based on routine clinicopathological parameters showed a low accuracy to predict SLN. A genomic test, as evaluated in the AGO-35 trial, may predict tumor response in the axilla more accurately to spare patients with pCR from surgical overtreatment.


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