The impact of axillary lymph-node dissection omission on adjuvant abemaciclib eligibility in HR-positive, HER2-negative breast cancer with positive sentinel lymph nodes.

IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Breast Cancer Pub Date : 2025-02-20 DOI:10.1007/s12282-025-01684-9
Kei Kawashima, Kazutaka Narui, Aya Nishikawa, Mahato Sasamoto, Masanori Oshi, Shoko Adachi, Akimitsu Yamada, Takashi Ishikawa, Itaru Endo
{"title":"The impact of axillary lymph-node dissection omission on adjuvant abemaciclib eligibility in HR-positive, HER2-negative breast cancer with positive sentinel lymph nodes.","authors":"Kei Kawashima, Kazutaka Narui, Aya Nishikawa, Mahato Sasamoto, Masanori Oshi, Shoko Adachi, Akimitsu Yamada, Takashi Ishikawa, Itaru Endo","doi":"10.1007/s12282-025-01684-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The MonarchE trial demonstrated the additional benefit of abemaciclib as an adjuvant endocrine therapy for high-risk patients with hormone receptor (HR)-positive HER2-negative breast cancer. Meanwhile, the ACOSOG Z0011 trial established the omission of axillary lymph-node dissection (ALND) as a standard practice in certain patients with positive sentinel lymph-node biopsy (SNB). However, as the MonarchE eligibility criteria include the presence of four or more lymph-node metastases, omitting ALND may hinder the assessment of abemaciclib eligibility in some cases.</p><p><strong>Methods: </strong>The study population consisted of patients with clinically node-negative, HR-positive, HER2-negative breast cancer who underwent SNB at our institution between January 2008 and December 2021. The proportion of patients meeting the MonarchE cohort1 criteria, and the potential impact of ALND omission on abemaciclib eligibility were assessed.</p><p><strong>Results: </strong>Among the 1537 patients, 189 underwent SNB followed by ALND due to the presence of one or more positive sentinel nodes. Of these, 69 (36.5%) were eligible for abemaciclib. Eligibility was uncertain without ALND in 138 patients. Among the 138 patients, 124 were candidates for ALND omission, including 11 who were found to have four or more metastatic lymph nodes after completing ALND.</p><p><strong>Conclusions: </strong>A few cases were identified in which abemaciclib eligibility was not properly determined due to ALND omission. This suggests that omitting ALND following SNB, when two of fewer positive nodes are detected, may not significantly impact the determination of abemaciclib eligibility.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12282-025-01684-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The MonarchE trial demonstrated the additional benefit of abemaciclib as an adjuvant endocrine therapy for high-risk patients with hormone receptor (HR)-positive HER2-negative breast cancer. Meanwhile, the ACOSOG Z0011 trial established the omission of axillary lymph-node dissection (ALND) as a standard practice in certain patients with positive sentinel lymph-node biopsy (SNB). However, as the MonarchE eligibility criteria include the presence of four or more lymph-node metastases, omitting ALND may hinder the assessment of abemaciclib eligibility in some cases.

Methods: The study population consisted of patients with clinically node-negative, HR-positive, HER2-negative breast cancer who underwent SNB at our institution between January 2008 and December 2021. The proportion of patients meeting the MonarchE cohort1 criteria, and the potential impact of ALND omission on abemaciclib eligibility were assessed.

Results: Among the 1537 patients, 189 underwent SNB followed by ALND due to the presence of one or more positive sentinel nodes. Of these, 69 (36.5%) were eligible for abemaciclib. Eligibility was uncertain without ALND in 138 patients. Among the 138 patients, 124 were candidates for ALND omission, including 11 who were found to have four or more metastatic lymph nodes after completing ALND.

Conclusions: A few cases were identified in which abemaciclib eligibility was not properly determined due to ALND omission. This suggests that omitting ALND following SNB, when two of fewer positive nodes are detected, may not significantly impact the determination of abemaciclib eligibility.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Breast Cancer
Breast Cancer ONCOLOGY-OBSTETRICS & GYNECOLOGY
CiteScore
6.70
自引率
2.50%
发文量
105
审稿时长
6-12 weeks
期刊介绍: Breast Cancer, the official journal of the Japanese Breast Cancer Society, publishes articles that contribute to progress in the field, in basic or translational research and also in clinical research, seeking to develop a new focus and new perspectives for all who are concerned with breast cancer. The journal welcomes all original articles describing clinical and epidemiological studies and laboratory investigations regarding breast cancer and related diseases. The journal will consider five types of articles: editorials, review articles, original articles, case reports, and rapid communications. Although editorials and review articles will principally be solicited by the editors, they can also be submitted for peer review, as in the case of original articles. The journal provides the best of up-to-date information on breast cancer, presenting readers with high-impact, original work focusing on pivotal issues.
期刊最新文献
c-Myc knockdown restores tamoxifen sensitivity in triple-negative breast cancer by reactivating the expression of ERα: the central role of miR-152 and miR-148a. Color differences of skin paddles using the free flap for autologous breast reconstruction in Asian patients. The complex role of regulatory cells in breast cancer: implication for immunopathogenesis and immunotherapy. Adjuvant chemotherapy in T1a/bN0 breast cancer with a high 21-gene recurrence score (> 25): a 10-year follow-up in a real-world cohort. The role of C1orf50 in breast cancer progression and prognosis.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1