Open AccessA new era of neoadjuvant treatment with Pertuzumab: Should the 10‐lymph node guideline for axillary lymph node dissection in breast cancer be revised?
Author(s) -
O'Leary Michael P.,
Beckord Brian J.,
Mock Kyle E.,
Venegas Rose J.,
Yeh James J.,
Dauphine Christine E.,
OzaoChoy Junko J.
Publication year - 2018
Publication title -
cancer reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 5
ISSN - 2573-8348
DOI - 10.1002/cnr2.1132
Subject(s) - pertuzumab , medicine , breast cancer , axillary lymph node dissection , neoadjuvant therapy , lymph node , axillary lymph nodes , oncology , axilla , cancer , sentinel lymph node , metastatic breast cancer
Background Pertuzumab has improved pathologic complete response rates when compared with other chemotherapeutics in the treatment of HER‐2 positive breast cancer patients. Aims We sought to determine if axillary lymph node dissections (ALNDs) yielding at least the national standard of 10 lymph nodes is lower in patients who received neoadjuvant pertuzumab. Methods and Results A retrospective database identified patients who underwent ALND for breast cancer. We compared the axillary lymph node retrieval rates in those who received or did not receive neoadjuvant pertuzumab. Of 139 breast cancer patients who underwent ALND, fewer than 10 axillary lymph nodes were found in 41.7% of patients who received neoadjuvant pertuzumab ( P < 0.01) and 18.6% of patients who received neoadjuvant therapy without pertuzumab ( P = 0.01). Conclusion Neoadjuvant chemotherapy was associated with a significantly lower rate of “adequate” ALNDs as defined by current guidelines. The patient subset that received neoadjuvant pertuzumab was more likely to have fewer than 10 axillary lymph nodes retrieved.