Describe the frequency and factors associated with the indication of Sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) and the impact of SLNB on prognosis
Sentinel lymph node biopsy after neoadjuvant chemotherapy in women with breast cancer: Clinical profile and prognosis
Autores: Marcelo Bello, Anke Bergmann, Marcelo Barbosa , Suzana Aguiar, Fabiana Tonellotto, Sergio Monteiro, Patricia Juca, Luiz Claudio Santos Thuler
Objectives: Describe the frequency and factors associated with the indication of Sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) and the impact of SLNB on prognosis. Methods: Retrospective cohort study of women with breast cancer submitted to NACT from january 2013 to july 2015 at Hospital do Cancer III of the National Cancer Institute (HCIII / INCA). The data were collected in electronic and physical records. This study was approved by INCA’s ethics and research committee. Results: A total of 783 women with mean age of 52 years (± 11) were included. The majority were diagnosed with clinical stage IIIA (23%) and IIIB (33%), and with a Luminal A subtype (ER+ and / or PR+, HER2-) (52%). After NACT, complete response was observed in 15% and partial in 58%. Mastectomy was performed in 85% of the women, and 25% were submitted to SLNB (alone 14% and SLNB + Lymphadenectomy 11%). The factors associated with SLNB were: Initial clinical stage (OR = 6.22 95%CI 4.28 – 9.06) and complete response to NACT (OR=1.96 CI95% 1.29 – 2.97). In the follow-up, were observed 23% of recurrence /metastasis and 13% of death. After adjustment (cT, cN and NACT response), there was no association between the performance of SLNB with recurrence/metastasis (HR=1.51 CI95% 0.93 – 2.46) and death (HR=1.48 CI95% 0.76 – 2.90). Conclusion: The indication of SLNB after NACT was associated with initial clinical stage and complete response to NACT. After adjustment, SLNB was not associated with prognosis.
Palavras-chave: Key words: breast cancer, sentinel lymph node biopsy, neoadjuvant chemotherapy, survival.