Clinical impact of the biology of synchronous axillary lymph node metastases in primary breast cancer on preoperative treatment strategy

• Published in: Journal of surgical oncology Vol. 123; no. 7; pp. 1513 - 1520
• Main Authors: Nakamura, Rikiya, Hayama, Shouko, Sonoda, Itaru, Miyaki, Toshiko, Itami, Makiko, Yamamoto, Naohito
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.06.2021
• Subjects: axillary lymph node metastases; biology; Breast cancer; Lymphatic system; Metastasis; preoperative systemic chemotherapy; synchronous; breast cancer; biology; preoperative systemic chemotherapy; synchronous; axillary lymph node metastases
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.26438

Background and objectives The purpose of this study was to assess the utility of determining the biological features of synchronous axillary lymph node (syLN) metastasis of breast cancer in evaluating the efficacy of preoperative systemic chemotherapy (PST). Materials and Methods The retrospective subjects initially comprised 59 patients (T1c‐4 N1‐3 M0) diagnosed with syLN metastasis via core needle biopsy who received PST. The hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status in each patient was assessed in primary breast tumor (pBT) and syLNs using immunohistochemistry, and the patients were classified into HR(+), HER2(+), and triple negative breast cancer (TN) subtypes. Results Subtype shift (SS) of pBT in syLNs was observed in 28% cases for HR(+), in 6% cases for the HER2(+), and in 16% cases for the TN. The pCR rate of the pBT and syLNs types were 45% and 36% in the HR(+), 45% and 39% in the TN, and 94% and 100% in the HER2(+), respectively. In SS cases, the pCR rate was significantly higher in 75% cases compared with 33% of the no‐SS cases. Conclusion A SS in syLNs was more frequent in HR(+) than in other types.