Abstract 93P
Background
The management pattern of axillary lymph nodes (ALN) in early-stage breast cancer patients with sentinel lymph node (SLN) micro-metastasis (SLNMM) and the prognosis are currently unclear in China. This study aimed to analyze the choice of clinical management and prognosis of patients with early-stage breast cancer combined with SLNMM in China.
Methods
This multicenter retrospective study included T1-3N0M0 female breast cancer patients who have undergone surgery and with SLNMM (including isolated tumor cells) from July 2019 to April 2023 at 5 centers in southern China. Characteristics of breast cancer, management patterns, and ALN metastasis were collected. The prognosis outcome included local recurrence (LR), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS).
Results
A total of 339 patients were included, with a mean age of 52.44±11.73 years. The baseline data showed a tumor length diameter of 2.20 (Interquartile range 1.60, 2.90) cm. Micrometastases were detected by intraoperative freezing in 196 (57.8%) patients, whereas 143 (42.2%) were negative intraoperatively and only detected by postoperative pathology. A total of 136 (40.1%) patients received ALN dissection (ALND) and 111 (33.1%) patients received radiotherapy. LR was observed in 4 (1.2%) patients, and DM was observed in 6 (1.8%) patients. With the median follow-up time of 26.73 (range 0.40, 57.13) months, median DFS and median OS were not reached. The 3-year DFS and 3-year OS were 97.2%, and 99.5%, respectively.
Conclusions
This study found that there are differences in the management of ALN in SLNMM patients of China, based on various surgical procedures for breast cancer. However, the rate of LR was low, thus omitted ALND might be a feasible ALN management option. Table: 93P
| n (%) | N=339 |
| Clinical staging | |
| T1 | 155 (46.1) |
| T2 | 170 (50.6) |
| T3 | 11 (3.3) |
| Molecular subtype | |
| Luminal A | 143 (42.4) |
| Luminal B | 138 (40.1) |
| Her-2 over-expression | 34 (10.1) |
| Triple-negative | 22 (6.5) |
| Number of sentinel lymph node micrometastases | |
| ITC | 15 (4.4) |
| 1-2 | 319 (94.1) |
| ≥3 | 5 (1.5) |
| Non-sentinel lymph node metastases | 20 (5.9) |
| Patients with mastectomy | 295 (87.0) |
| Underwent ALND | 125 (42.4) |
| Radiotherapy only | 46 (15.6) |
| Observation only | 124 (42.0) |
| Patients with breast-conserving | 37 (10.9) |
| Underwent ALND | 8 (21.6) |
| Radiotherapy only | 25 (67.6) |
| Observation only | 3 (10.8) |
| Patients with breast reconstruction | 7 (2.1) |
| 3-years DFS (%) | 97.2% |
| 3-years OS (%) | 99.5% |
ITC: Isolated tumor cells; ALND: Axillary lymph node dissection; DFS: Disease-free survival; OS: Overall survival.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.