A recent study led by Dr. Neslihan Cabıoğlu from the Department of General Surgery at Istanbul Faculty of Medicine sheds light on new surgical approaches for breast cancer treatment. The research, published online in JAMA Surgery, is a subgroup analysis of the NEOSENTITURK MF-1803 study, focusing on patients with clinically node-positive breast cancer downstaged to node-negative after neoadjuvant chemotherapy. This study involved 976 participants with a median age of 46, exploring the outcomes of sentinel lymph node biopsy (SLNB) and targeted axillary dissection.
Participants were assigned to either SLNB alone, with 620 cases, or targeted axillary dissection alone, involving 356 cases. The study utilized mapping procedures, predominantly relying on single tracer techniques (69.8%) and blue dye (66.1%). The follow-up period averaged at 38.9 months, providing significant data for analysis.
The results revealed that patients who underwent targeted axillary dissection experienced a lower systemic recurrence rate compared to those who had SLNB (3.4% vs 5.8%). Additionally, the 5-year disease-free survival (DFS) rate was slightly higher for the targeted axillary dissection group (94.9% vs 92.6%). Despite these differences, the variations in systemic recurrence and DFS rates were not statistically significant. Furthermore, the dual mapping approach was more commonly used in targeted axillary dissection cases (44.1% vs 22.3%).
“Our findings from the short-term follow-up suggest axillary and locoregional recurrences at very low rates.”
— Neslihan Cabıoğlu, MD, PhD
Advanced clinical nodal stage (cN2-3) and nonluminal tumor characteristics were linked to lower 5-year disease-specific survival rates. Specifically, the rates were 98.7% for cN1, 96.8% for cN2-3, 98.9% for luminal tumors, and 96.9% for nonluminal tumors.
“Whether [targeted axillary dissection] might provide a clear survival advantage compared with SLNB remains to be proven in studies with longer follow-up.”
— Neslihan Cabıoğlu, MD, PhD
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