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13.03.2018 | Original Article

Comparison of sentinel lymph node biopsy between invasive lobular carcinoma and invasive ductal carcinoma

verfasst von: Yayoi Adachi, Masataka Sawaki, Masaya Hattori, Akiyo Yoshimura, Noami Gondo, Haruru Kotani, Madoka Iwase, Ayumi Kataoka, Sakura Onishi, Kayoko Sugino, Mitsuo Terada, Nanae Horisawa, Makiko Mori, Isao Oze, Hiroji Iwata

Erschienen in: Breast Cancer | Ausgabe 5/2018

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Abstract

Background

Recent studies suggested that ALND (axillary lymph node dissection) can be avoided in breast cancer patients with limited SLN (sentinel lymph node) metastasis. However, these trials included only several invasive lobular carcinoma (ILC) cases, and the validity of omitting ALND for ILC remains controversial. Here, we examined whether omitting ALND is feasible in ILC treatment.

Methods

A total of 3771 breast cancer patients underwent surgery for breast cancer at the Aichi Cancer Center Hospital between January 2006 and December 2015. We excluded patients with neoadjuvant therapy or without axillary management, and identified 184 ILC patients and 2402 invasive ductal carcinoma (IDC) patients. We compared SLN and non-SLN metastasis rates and the number of total ALN metastases between the ILC and IDC cohorts, and we examined the factors that influenced non-SLN metastasis in the SLN micrometastasis group.

Results

SLN biopsies were performed in 171 (93%) ILC and 2168 (90%) IDC cases, and 31 (18%) ILC and 457 (21%) IDC cases were SLN micrometastasis and macrometastasis (p = 0.36). Among SLN macrometastasis patients, 17 (68%) ILC cases and 163 (46%) IDC cases showed non-SLN metastasis (p = 0.03). The number of non-SLN metastases was greater in ILC cases compared with IDC cases. Multivariate analysis showed that ILC was the influential factor predicting non-SLN metastasis in patients with SLN macrometastasis.

Conclusion

ILC cases had more non-SLN metastasis than IDC cases among SLN-positive cases, and ILC was an important factor for the prediction of non-SLN positivity in SLN macrometastasis cases. Omitting ALND for ILC with positive SLNs requires more consideration.

Hoda SA, Brogi E, Koerner FC, Rosen PP. Rosen’s breast pathology. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2014. p. 855–92.

Cristofanilli M, Gonzalez-Angulo A, Sneige N, Kau SW, Broglio K, Theriault RL, et al. Invasive lobular carcinoma classic type: response to primary chemotherapy and survival outcomes. J Clin Oncol. 2005;23:41–8.CrossRefPubMed

Korkola JE, DeVries S, Fridlyand J, Hwang ES, Estep AL, Chen YY, et al. Differentiation of lobular versus ductal breast carcinomas by expression microarray analysis. Cancer Res. 2003;63:7167–75.PubMed

Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T, et al. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol. 2007;8:881–8.CrossRefPubMed

Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003;349:546–53.CrossRefPubMed

Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomised controlled study. Lancet Oncol. 2006;7:983–90.CrossRefPubMed

Boler DE, Uras C, Ince U, Cabioglu N. Factors predicting the non-sentinel lymph node involvement in breast cancer patients with sentinel lymph node metastases. Breast. 2012;21:518–23.CrossRefPubMed

Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013;14:297–305.CrossRefPubMedPubMedCentral

Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014;15:1303–10.CrossRefPubMedPubMedCentral

10.

Giuliano AE, Ballman KV, McCall L, Beitsch PD, Brennan MB, Kelemen PR, et al. Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women With Invasive Breast Cancer and Sentinel Node Metastasis: the ACOSOG Z0011 (Alliance) Randomized Clinical Trial. JAMA. 2017;318:918–26.CrossRefPubMedPubMedCentral

11.

Lambert LA, Ayers GD, Meric-Bernstam F. Validation of a breast cancer nomogram for predicting nonsentinel lymph node metastases after a positive sentinel node biopsy. Ann Surg Oncol. 2007;14:2422–3.CrossRefPubMed

12.

Kohrt HE, Olshen RA, Bermas HR, Goodson WH, Wood DJ, Henry S, et al. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients. BMC Cancer. 2008;8:66.CrossRefPubMedPubMedCentral

13.

Pestalozzi BC, Zahrieh D, Mallon E, Gusterson BA, Price KN, Gelber RD, et al. Distinct clinical and prognostic features of infiltrating lobular carcinoma of the breast: combined results of 15 International Breast Cancer Study Group clinical trials. J Clin Oncol. 2008;26:3006–14.CrossRefPubMed

14.

Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 2004;6:R149–56.CrossRefPubMedPubMedCentral

15.

Fernandez B, Paish EC, Green AR, Lee AH, Macmillan RD, Ellis IO, et al. Lymph-node metastases in invasive lobular carcinoma are different from those in ductal carcinoma of the breast. J Clin Pathol. 2011;64:995–1000.CrossRefPubMed

16.

Topps A, Clay V, Absar M, Howe M, Lim Y, Johnson R, et al. The sensitivity of pre-operative axillary staging in breast cancer: comparison of invasive lobular and ductal carcinoma. Eur J Surg Oncol. 2014;40:813–7.CrossRefPubMed

17.

Christgen M, Derksen P. Lobular breast cancer: molecular basis, mouse and cellular models. Breast Cancer Res. 2015;17:16.CrossRefPubMedPubMedCentral

18.

Rakha EA, El-Sayed ME, Powe DG, Green AR, Habashy H, Grainge MJ, et al. Invasive lobular carcinoma of the breast: response to hormonal therapy and outcomes. Eur J Cancer. 2008;44:73–83.CrossRefPubMed

19.

Biglia N, Maggiorotto F, Liberale V, Bounous VE, Sgro LG, Pecchio S, et al. Clinical-pathologic features, long term-outcome and surgical treatment in a large series of patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC). Eur J Surg Oncol. 2013;39:455–60.CrossRefPubMed

20.

Abdessalam SF, Zervos EE, Prasad M, Farrar WB, Yee LD, Walker MJ, et al. Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer. Am J Surg. 2001;182:316–20.CrossRefPubMed

21.

Viale G, Maiorano E, Pruneri G, Mastropasqua MG, Valentini S, Galimberti V, et al. Predicting the risk for additional axillary metastases in patients with breast carcinoma and positive sentinel lymph node biopsy. Ann Surg. 2005;241:319–25.CrossRefPubMedPubMedCentral

22.

Roberts A, Nofech-Mozes S, Youngson B, McCready DR, Al-Assi M, Ramkumar S, et al. The importance of applying ACOSOG Z0011 criteria in the axillary management of invasive lobular carcinoma: a multi-institutional cohort study. Ann Surg Oncol. 2015;22:3397–401.CrossRefPubMed

23.

Adachi Y, Ishiguro J, Kotani H, Hisada T, Ichikawa M, Gondo N, et al. Comparison of clinical outcomes between luminal invasive ductal carcinoma and luminal invasive lobular carcinoma. BMC Cancer. 2016;16:248.CrossRefPubMedPubMedCentral

24.

Santiago RJ, Harris EE, Qin L, Hwang WT, Solin LJ. Similar long-term results of breast-conservation treatment for Stage I and II invasive lobular carcinoma compared with invasive ductal carcinoma of the breast: the University of Pennsylvania experience. Cancer. 2005;103:2447–54.CrossRefPubMed

Titel: Comparison of sentinel lymph node biopsy between invasive lobular carcinoma and invasive ductal carcinoma
verfasst von: Yayoi Adachi
Masataka Sawaki
Masaya Hattori
Akiyo Yoshimura
Noami Gondo
Haruru Kotani
Madoka Iwase
Ayumi Kataoka
Sakura Onishi
Kayoko Sugino
Mitsuo Terada
Nanae Horisawa
Makiko Mori
Isao Oze
Hiroji Iwata
Publikationsdatum: 13.03.2018
Verlag: Springer Japan
Erschienen in: Breast Cancer / Ausgabe 5/2018
Print ISSN: 1340-6868
Elektronische ISSN: 1880-4233
DOI: https://doi.org/10.1007/s12282-018-0852-x

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Comparison of sentinel lymph node biopsy between invasive lobular carcinoma and invasive ductal carcinoma