SABCS 2022 Takeaways - 16

16 SURGICAL SPOTLIGHT
"
Giacomo Montagna, MD, MPH
Nodal Sparing in Early-Stage Disease
A
large retrospective
study led by
Giacomo Montagna,
MD, MPH, showed that
axillary lymph node
dissection can be safely
omitted for patients
who achieve complete
nodal response
after chemotherapy,
with very low rates of
axillary recurrence
rates at 5 years. The
Trial Population
Total pts
Median # of sentinel nodes
removed
Mean # of nodes removed
Received nodal irradiation
Received adjuvant chemotherapy
Trial Results
3-year cumulative incidence of
isolated axillary recurrence
3-year cumulative incidence of
locoregional recurrence
3-year cumulative incidence of
invasive recurrence
study found this to
be true regardless of
type of axillary staging:
sentinel lymph node
biopsy (SLNB) with
dual tracer mapping
or targeted axillary
dissection (TAD).
" Early axillary recurrence
after omission
of axillary lymph node
dissection in patients
who start out as node
SLNB
666
4
4.4
78%
4.5%
0.8%
1.9%
7.3%
positive and convert to
node negative with neoadjuvant
chemotherapy
is a very rare event, " Dr.
Montagna said during
his presentation. " Axillary
recurrence was not
significantly lower with
TAD than with sentinel
lymph node biopsy,
in spite of more TAD
patients receiving nodal
irradiation. "
TAD
478
3
3.9
85%
8.6%
0.5%
0.8%
7.8%
P VALUE
Total pts
< 0.001
< 0.001
= 0.005
= 0.005
= 0.55
= 0.19
= 0.60
The OPBC-04/EUBREAST-06/OMA
study presented
by Dr. Montagna is
really an exciting study that
shows that in node-positive
patients who experience
axillary pathologic complete
response after neoadjuvant
chemotherapy either
sentinel lymph node biopsy
with dual tracer mapping or
targeted axillary dissection
(TAD) alone (and therefore
omission of ALND) are oncologically
safe. Although there
were comparable outcomes
using sentinel node biopsy
or TAD, long-term follow up
will be important to evaluate
this further. "
Mediget Teshome, MD
BY THE NUMBERS
» 1,144 patients who
had T1-T4/N1N3
breast cancer
determined by biopsy
» 100% received
neoadjuvant
chemotherapy
» Tumor Biology
* HER2+ : 54%
* HR-/HER-: 23%
* HR+/HER2- : 23%
Mediget Teshome, MD
SABCS TAKEAWAYS EDITION

SABCS 2022 Takeaways

Table of Contents for the Digital Edition of SABCS 2022 Takeaways

SABCS 2022 Takeaways - A
SABCS 2022 Takeaways - 1
SABCS 2022 Takeaways - 2
SABCS 2022 Takeaways - 3
SABCS 2022 Takeaways - 4
SABCS 2022 Takeaways - 5
SABCS 2022 Takeaways - 6
SABCS 2022 Takeaways - 7
SABCS 2022 Takeaways - 8
SABCS 2022 Takeaways - 9
SABCS 2022 Takeaways - 10
SABCS 2022 Takeaways - 11
SABCS 2022 Takeaways - 12
SABCS 2022 Takeaways - 13
SABCS 2022 Takeaways - 14
SABCS 2022 Takeaways - 15
SABCS 2022 Takeaways - 16
SABCS 2022 Takeaways - 17
https://www.nxtbookmedia.com