Prognostic effect of nodal status before and after neoadjuvant chemotherapy in breast cancer:a Dutch population-based study

Purpose: In breast cancer, neoadjuvant chemotherapy (NAC) can downstage the nodal status, and can even result in a pathological complete response, which is associated with improved prognosis. This study aimed to determine the prognostic effect of nodal status before and after NAC. Methods: Women with breast cancer treated with NAC were selected from the Netherlands Cancer Registry if diagnosed between 2005 and 2019, and classified based on nodal status before NAC: node-negative (cN0), or node-positive based on fine needle aspiration cytology or core needle biopsy (cN+). Subgroups were based on... Mehr ...

Verfasser: de Wild, Sabine R.
Koppert, Linetta B.
de Munck, Linda
Peeters, Marie-Jeanne T. F. D. Vrancken
Siesling, Sabine
Smidt, Marjolein L.
Simons, Janine M.
Dokumenttyp: Artikel
Erscheinungsdatum: 2024
Reihe/Periodikum: de Wild , S R , Koppert , L B , de Munck , L , Peeters , M-J T F D V , Siesling , S , Smidt , M L & Simons , J M 2024 , ' Prognostic effect of nodal status before and after neoadjuvant chemotherapy in breast cancer : a Dutch population-based study ' , Breast Cancer Research and Treatment , vol. 204 , no. 2 , pp. 277-288 . https://doi.org/10.1007/s10549-023-07178-6
Schlagwörter: Breast cancer / Neoadjuvant chemotherapy / Nodal status / Prognosis / PATHOLOGICAL COMPLETE RESPONSE / RADIOACTIVE IODINE SEEDS / PREOPERATIVE CHEMOTHERAPY / AXILLARY DISSECTION / TUMOR BIOLOGY / METASTASES / SURVIVAL / THERAPY / MARKING / SURGERY
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29021152
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://cris.maastrichtuniversity.nl/en/publications/7685f18d-5853-47c9-a35b-4707984e7ee0

Purpose: In breast cancer, neoadjuvant chemotherapy (NAC) can downstage the nodal status, and can even result in a pathological complete response, which is associated with improved prognosis. This study aimed to determine the prognostic effect of nodal status before and after NAC. Methods: Women with breast cancer treated with NAC were selected from the Netherlands Cancer Registry if diagnosed between 2005 and 2019, and classified based on nodal status before NAC: node-negative (cN0), or node-positive based on fine needle aspiration cytology or core needle biopsy (cN+). Subgroups were based on nodal status after NAC: absence (ypN0) or presence (ypN+) of nodal disease. Five-year overall survival (OS) was assessed with Kaplan–Meier survival analyses, also per breast cancer molecular subtype. To adjust for potential confounders, multivariable analyses were performed. Results: A total of 6,580 patients were included in the cN0 group, and 11,878 in the cN+ group. The 5-year OS of the cN0ypN0-subgroup was statistically significant better than that of the cN+ypN0-subgroup (94.4% versus 90.1%, p < 0.0001). In cN0 as well as cN+ disease, ypN+ had a statistically significant worse 5-year OS compared to ypN0. For hormone receptor (HR)+ human epidermal growth factor receptor 2 (HER2)−, HR+ HER2+, HR-HER2+, and triple negative disease, respectively, 5-year OS in the cN0ypN+-subgroup was 89.7%, 90.4%, 73.7%, and 53.6%, and in the cN+ypN+-subgroup 84.7%, 83.2%, 61.4%, and 48.8%. In multivariable analyses, cN+ and ypN+ disease were both associated with worse OS. Conclusion: This study suggests that both cN-status and ypN-status, and molecular subtype should be considered to further improve prognostication.