Background:This study aimed to evaluate the lymph node (LN) response in Her2-positive breast cancer patients who received neoadjuvant therapy (NAT) and to discuss if axillary staging can be omitted in these patients.Methods:This is a retrospective cohort study including patients with Her2+ breast cancer at our center from March 2022 to September 2023.Results:The study included 139 patients in the final analysis; 69.1% of the patients had HR+/Her2+ disease while 30.9% had HR−/Her2+ disease. Most of the included patients (129 patients = 92.8%) had initially node-positive or suspicious disease. A total of 112 patients (80.6%) showed clinically negative axillary LNs (cN0) after NAT. All of them showed pathologically node-negative disease. When comparing the pathological node-positive vs. -negative groups, the following was found to be statistically significant: degree of Her2 positivity, number of anti-Her2 cycles, pre- and post-neoadjuvant LN status, and primary tumor radiological and pathological response. Also, all T1 tumors before NAT showed negative LNs after NAT, but it was statistically non-significant.Conclusions:Axillary staging may be omitted in Her2+ patients with cN0 after NAT, especially those with early tumors, strong Her2+ disease, cN0 before NAT, and those in whom the primary tumor achieved a complete clinical response.
背景：本研究旨在评估接受新辅助治疗（NAT）的Her2阳性乳腺癌患者淋巴结（LN）反应，并探讨此类患者是否可省略腋窝分期。 方法：本研究为回顾性队列研究，纳入2022年3月至2023年9月期间本中心收治的Her2阳性乳腺癌患者。 结果：最终分析共纳入139例患者；其中69.1%为HR+/Her2+型，30.9%为HR−/Her2+型。大多数患者（129例，占92.8%）初始淋巴结状态为阳性或可疑。NAT后共有112例患者（80.6%）临床腋窝淋巴结阴性（cN0），且所有患者病理学检查均显示淋巴结阴性。对比病理淋巴结阳性与阴性组发现以下因素具有统计学显著性：Her2阳性程度、抗Her2治疗周期数、新辅助治疗前后淋巴结状态、原发肿瘤影像学及病理学反应。此外，所有NAT前T1期肿瘤在NAT后均显示淋巴结阴性，但该结果无统计学显著性。 结论：对于NAT后达到cN0的Her2阳性患者，尤其是早期肿瘤、Her2强阳性、NAT前cN0以及原发肿瘤达到完全临床缓解的患者，可考虑省略腋窝分期。
肿瘤(癌症)患者之家