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Predicting Additional Metastases in Axillary Lymph Node Dissection After Neoadjuvant Chemotherapy: Ratio of Positive/Total Sentinel Nodes. | LitMetric

AI Article Synopsis

  • The study aimed to assess the significance of the sentinel lymph node ratio (SLN-R) in predicting additional positive lymph nodes during axillary lymph node dissection (ALND) in breast cancer patients after neoadjuvant chemotherapy (NAC).
  • Researchers analyzed data from 118 out of 1521 breast cancer patients, identifying two groups based on whether they had additional node metastasis at ALND.
  • Findings revealed that an SLN-R of <0.35 could predict the absence of further metastasis with a 10.2% false-negative rate, suggesting it could help avoid unnecessary ALND in certain patients.

Article Abstract

Background/objectives: The aim of the study was to determine the clinical value of the sentinel lymph node ratio (SLN-R) in predicting additional positive lymph nodes during axillary lymph node dissection (ALND) in breast cancer patients following neoadjuvant chemotherapy (NAC).

Methods: A cross-sectional study was performed at a single institution evaluating data from 1521 BC patients. Inclusion criteria comprised cT1/cT4, cN0/cN1 status with positive post-NAC axillary staging by SLN/TAD, respectively, and subsequent ALND.

Results: The study included 118 patients, divided into two groups based on the presence or absence of additional node metastasis at ALND: 39 in the residual disease group (RD) and 79 in the non-residual disease group (nRD). Univariate logistic regression analysis of SLN-R was conducted to assess its predictive value, yielding an odds ratio (OR) of 7.79 (CI 1.92-29.5, = 0.003). An SLN-R cut-off point of <0.35 was identified using ROC curve analysis, with a false-negative rate of 10.2%, as a predictor for no additional metastasis at ALND following post-NAC SLN/TAD positivity.

Conclusions: The study concludes that SLN-R is a valuable predictor for determining the omission of ALND in cases where SLN/TAD is positive after NAC. This metric, in combination with other clinical variables, could help develop a nomogram to spare patients from ALND.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545455PMC
http://dx.doi.org/10.3390/cancers16213638DOI Listing

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