Annals of Surgical Oncology Cite Track
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lenert, J. T.
Right arrow Articles by Singletary, S. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lenert, J. T.
Right arrow Articles by Singletary, S. E.

Annals of Surgical Oncology, Vol 6, Issue 8 762-767, Copyright © 1999 by Society of Surgical Oncology

ARTICLES

Primary tumor response to induction chemotherapy as a predictor of histological status of axillary nodes in operable breast cancer patients

J. T. Lenert, G. Vlastos, N. Q. Mirza, D. J. Winchester, S. M. Binkley, F. C. Ames, M. I. Ross, B. W. Feig, K. K. Hunt, E. Strom, A. U. Buzdar, G. N. Hortobagyi and S. E. Singletary
Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.

BACKGROUND: Routine use of axillary lymph node dissection is being questioned, especially in clinically NO patients. The goal of this study was to determine whether primary tumor response to induction chemotherapy (IC) can predict the histological volume of residual axillary disease in patients who were candidates for breast conservation surgery after IC. METHODS: Forty-seven patients with stage II or IIIA breast cancer who received breast conservation surgery were selected from a population of patients randomized to receive four cycles of IC. Largest clinical tumor size before and after IC was determined by physical examination, mammography, and breast ultrasound. Clinical nodal status was determined by physical examination and axillary ultrasound and compared with histological findings. RESULTS: In patients with at least 50% reduction in primary tumor size after IC, 12 of 14 (86%) NO patients and 11 of 17 (65%) N1 patients were histologically negative. In patients with a less than 50% reduction, 0 of 3 NO patients and 2 of 13 (15%) N1 patients were histologically negative. CONCLUSIONS: There is significantly less axillary disease in responders than in nonresponders after IC. For NO responders, axillary irradiation may be an acceptable alternative to axillary lymph node dissection, and could easily be incorporated into the postsurgical radiotherapy that is standard protocol for breast conservation therapy. The more aggressive disease in nonresponders is best treated by axillary lymph node dissection, pending further study.


This article has been cited by other articles:


Home page
 Ann. Surg. Oncol.Home page
P. F. Escobar, R. J. Patrick, L. A. Rybicki, D. Hicks, D. E. Weng, and J. P. Crowe
Prognostic Significance of Residual Breast Disease and Axillary Node Involvement for Patients Who Had Primary Induction Chemotherapy for Advanced Breast Cancer
Ann. Surg. Oncol., June 1, 2006; 13(6): 783 - 787.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
S. E. Singletary
Candidates for Minimally Invasive Therapy of Breast Cancer: Redefining the Standards
Ann. Surg. Oncol., July 1, 2003; 10(6): 591 - 592.
[Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
J. S. Fant, M. D. Grant, S. M. Knox, S. A. Livingston, K. Ridl, R. C. Jones, and J. A. Kuhn
Preliminary Outcome Analysis in Patients With Breast Cancer and a Positive Sentinel Lymph Node Who Declined Axillary Dissection
Ann. Surg. Oncol., March 1, 2003; 10(2): 126 - 130.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1999 by the Society of Surgical Oncology.