Study findings suggest that both sentinel lymph node biopsy (SLNB) and targeted axillary dissection are effective in treating patients with clinically node-negative breast cancer after neoadjuvant chemotherapy, with low rates of recurrence.
Patients with clinically node-negative breast cancer following neoadjuvant chemotherapy experienced very low rates of axillary and locoregional recurrence after undergoing either sentinel lymph node biopsy (SLNB) or targeted axillary dissection . Traditionally, more conservative treatment options, such as SLNB and targeted axillary dissection , have been considered for women with node-positive breast cancer .
However, comparing patient outcomes between targeted axillary dissection and SLNB has been limited. Researchers conducted a subgroup analysis of the NEOSENTITURK MF-1803 study, a prospective, multicenter trial that included patients with clinically node-positive breast cancer who achieved downstaging to node-negative disease after neoadjuvant chemotherapy. The study encompassed 976 participants (median age, 46 years) who underwent either SLNB alone (n=620) or targeted axillary dissection alone (n=356). The lymph node mapping process involved either a single tracer (69.8%) or a dual tracer (30.2%) approach. The primary outcomes evaluated included axillary or locoregional recurrence rates, as well as disease-free survival (DFS) and disease-specific survival.The mean follow-up period was 38.9 months. Notably, most participants underwent mapping using blue dye alone (66.1%). Patients who received targeted axillary dissection were more likely to undergo mapping with the dual approach (44.1% vs 22.3% for SLNB). The analysis revealed no significant differences in axillary, locoregional, or regional recurrence rates between the two groups. SLNB patients exhibited similar low rates of ipsilateral axillary recurrence (0.3% vs 0.3% for targeted axillary dissection) and locoregional recurrence (1.1% vs 0.6%, respectively). Targeted axillary dissection was associated with a lower systemic recurrence rate compared to SLNB (3.4% vs 5.8%). Advanced clinical nodal stage (cN2-3) and nonluminal tumor characteristics were linked to statistically significant lower 5-year disease-specific survival rates: cN1 (98.7%) vs cN2-3 (96.8%), and luminal (98.9%) vs nonluminal (96.9%). The study authors concluded that their short-term follow-up findings suggest very low rates of axillary and locoregional recurrence after either SLNB or targeted axillary dissection, without axillary lymph node dissection, regardless of SLN pathological findings. However, they emphasized that longer follow-up studies are needed to determine if one approach offers a clear survival advantage over the other
Breast Cancer Neoadjuvant Chemotherapy Sentinel Lymph Node Biopsy Targeted Axillary Dissection Recurrence Survival
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