SSO 2024: Nodal Isolated Tumor Cells and Axillary Dissection in Breast Cancer

By: Joshua D. Madera, MD
Posted: Monday, March 25, 2024

For patients with breast cancer who have residual isolated tumor cells in the sentinel lymph node after treatment with neoadjuvant chemotherapy, the risk of identifying additional positive lymph nodes remains elusive, according to a plenary session presented at the 2024 Society of Surgical Oncology (SSO) Annual Meeting (Abstract 1). The study findings revealed that the use of axillary lymph node dissection as a therapeutic intervention does not seem to provide any clinical benefit in this patient population, explained Giacomo Montagna, MD, MPH, of Memorial Sloan Kettering Cancer Center, New York, and colleagues.

From 2009 to 2022, a total of 412 patients with breast cancer were recruited for the study. Patients were treated with neoadjuvant chemotherapy plus axillary staging, with either targeted axillary dissection or sentinel lymph node biopsy. All had residual isolated tumor cells. After the completion of axillary staging, patients received axillary treatment with completion axillary lymph node dissection with or without nodal radiotherapy. Clinical outcomes were monitored regularly to assess for disease recurrence.

The study authors reported that patients who received axillary treatment with completion axillary lymph node dissection had an increased number of isolated tumor cells identified on frozen section (61%) and increased evidence of lymphovascular invasion (40%). In addition, positive nodes were identified in 29.5% of patients who had completion axillary lymph node dissection. These positive nodes demonstrated evidence of isolated tumor cells (15.8%), macrometastases (7.5%), and micrometastases (6.2%). Furthermore, the 5-year rates of locoregional recurrence, axillary recurrence, and any invasive recurrence were 2.8%, 2.7%, and 16.0%, respectively.

Disclosure: Dr. Montagna reported no conflicts of interest. For full disclosures of the other study authors, visit eventscribe.net.

2024 SSO Annual Meeting

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