Background: Several prospective studies have found that local surgical resection did not improve the survival of patients with metastatic breast cancer (dnMBC). However, a significant portion of dnMBC patients still undergo local surgery, and the role of axillary lymph node dissection (ALND) in dnMBC patients remains unclear. This study aimed to investigate the effect of ALND in patients with dnMBC.
Methods: We included patients diagnosed with dnMBC between 2010 and 2020 using the data from the Surveillance, Epidemiology, and End Results program. The Chi-square test, binomial logistic regression, propensity score matching (PSM), Kaplan-Meier method, and multivariate Cox proportional models were employed for statistical analysis.
Results: A total of 6,838 patients were identified, with 5,562 (81.3%) in the ALND group and 1,276 (18.7%) in the non-ALND group. Being diagnosed in later years emerged as an independent predictive factor related to the receipt of ALND (P=0.003). Before PSM, the 5-year breast cancer-specific survival (BCSS) was 51.1% and 38.2% in those with and without ALND, respectively (P<0.001). The 5-year overall survival (OS) was 45.9% and 32.3% in those with and without ALND, respectively (P<0.001). ALND was identified as an independent prognostic factor related to better BCSS (P<0.001) and OS (P<0.001) compared to the non-ALND group. Similar findings were observed after PSM. The outcomes were significantly better in the ALND group than in the non-ALND group in most subgroups. However, the number of removed lymph nodes did not show a significant association with BCSS (P=0.27) and OS (P=0.29).
Conclusions: Our study suggests that ALND is associated with improved survival outcomes in dnMBC patients. These findings advocate for a re-evaluation of the role of surgical interventions in dnMBC, emphasizing the need for personalized treatment strategies that consider the potential benefits of ALND.
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http://dx.doi.org/10.21037/gs-24-130 | DOI Listing |
Eur Radiol
December 2024
Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.
Objectives: Quality control in breast cancer screening programmes has been subject of several studies. However, less is known about the clinical diagnostic work-up in recalled women with a suspicious finding at screening mammography. The current study focuses on interhospital differences in diagnostic work-up strategies.
View Article and Find Full Text PDFBreast Cancer (Dove Med Press)
December 2024
Department of Radiology, People's Hospital of Henan University, Zhengzhou, Henan, People's Republic of China.
Background: Core biopsy sampling may not fully capture tumor heterogeneity. Radiomics provides a non-invasive method to assess tumor characteristics, including both the core and surrounding tissue, with the potential to improve the accuracy of HER-2 status prediction.
Objective: To explore the clinical value of intratumoral and peritumoral radiomics features from dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) for preoperative prediction of human epidermal growth factor receptor-2 (HER-2) expression status in breast cancer.
Med Phys
December 2024
The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, Texas, USA.
Background: Automation in radiotherapy presents a promising solution to the increasing cancer burden and workforce shortages. However, existing automated methods for breast radiotherapy lack a comprehensive, end-to-end solution that meets varying standards of care.
Purpose: This study aims to develop a complete portfolio of automated radiotherapy treatment planning for intact breasts, tailored to individual patient factors, clinical approaches, and available resources.
Quant Imaging Med Surg
December 2024
Department of Radiology, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
Background: The heterogeneity within breast cancer and its microenvironment are associated with metastasis. Analyzing distinct tumor subregions using habitat analysis and characterizing the tumor microenvironment through radiomics may be valuable for predicting axillary lymph node metastasis (ALNM) in breast cancer. This study aimed to develop and validate a nomogram for predicting ALNM in breast cancer patients by integrating clinicopathological, intra- or peri-tumoral radiomic, and habitat signatures based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and determine the optimal peritumoral region size for accurate prediction.
View Article and Find Full Text PDFCureus
November 2024
Department of Pathology, Father Muller Medical College, Mangalore, IND.
Axillary swellings, particularly in women, often raise suspicion due to the high association of such swellings with breast carcinoma manifesting as metastatic lymph node involvement. Tuberculous lymphadenopathy is one of the primary diagnoses in India. Fibroadenomas are common benign breast tumors, but their occurrence in the axilla, arising from ectopic breast tissue (EBT), is rare and may present a diagnostic challenge.
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