An objective nodal staging system for breast cancer patients undergoing neoadjuvant systemic treatment

Bibliographic Details
Title: An objective nodal staging system for breast cancer patients undergoing neoadjuvant systemic treatment
Authors: Tae-Kyung Yoo, Jung Min Chang, Hee-Chul Shin, Wonshik Han, Dong-Young Noh, Hyeong-Gon Moon
Source: BMC Cancer, Vol 17, Iss 1, Pp 1-9 (2017)
Publisher Information: BMC, 2017.
Publication Year: 2017
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Breast cancer, Neoadjuvant systemic therapy, Nodal staging, Chest CT, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract Background In this study, we aimed to develop an objective staging system to determine the degree of nodal metastasis in breast cancer patients undergoing neoadjuvant systemic treatment (NST). Methods We reviewed the pretreatment computed tomography (CT) images of 392 breast cancer patients who received NST. The association between the patterns of the enlarged regional lymph nodes and treatment outcome was analyzed. Results In the development cohort of 260 patients, 88 (33.8%) patients experienced tumor recurrence and had a significantly higher number of enlarged lymph nodes on the pretreatment CT compared to patients with no recurrence. When patients were classified according to the numbers and locations of enlarged lymph nodes on pretreatment CT, the number of lymph nodes larger than 1 cm was most significantly associated with tumor recurrence. The accuracy of the CT-based nodal staging system was validated in an independent cohort of 132 patients. The presence of the enlarged supraclavicular nodes was associated with worse outcome, but the effect seemed to originate from the accompanied extensive axillary nodal burden. The prognostic effect of the objectively measured axillary nodal metastasis was more pronounced in hormone receptor-negative tumors. Conclusions We have developed and validated an objective method of nodal staging in breast cancer patients who undergo NST based on the number of enlarged axillary lymph nodes. Our system can improve the current subjective approach, which uses physical examination alone.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2407
Relation: http://link.springer.com/article/10.1186/s12885-017-3380-8; https://doaj.org/toc/1471-2407
DOI: 10.1186/s12885-017-3380-8
Access URL: https://doaj.org/article/3b832374cc1d4c50a490cdfcd9a55f90
Accession Number: edsdoj.3b832374cc1d4c50a490cdfcd9a55f90
Database: Directory of Open Access Journals
More Details
ISSN:14712407
DOI:10.1186/s12885-017-3380-8
Published in:BMC Cancer
Language:English