Biópsia de Linfonodo Sentinela após Quimioterapia Neoadjuvante em Câncer de Mama: Resultados da Vida Real
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n3.4683Keywords:
Drug Therapy, Breast Neoplasms/surgery, Lymph Node Excision, Sentinel Lymph Node Biopsy, DemographyAbstract
Introduction: Breast cancer (BC) is the most common cancer among women. Neoadjuvant chemotherapy (NAC) aims to improve surgical conditions in patients with locally advanced BC. Objective: Compare demographic, clinical and treatment characteristics of women undergoing NAC for BC treatment according to axillary lymphadenectomy (AL) or sentinel lymph node biopsy (SLNB) and analyze factors associated with indication of SLNB in a real-life scenario. Method: Retrospective cohort study of women with BC and indication for NAC. Demographic, clinical, tumor and treatment variations were obtained. Simple and multiple logistic regression was performed to evaluate the independent factors associated with SLNB indication. Results: 918 patients were included, of which 17.5% underwent SLNB and 11.4%, SLNB followed by AL. Women in stage III were 95% less likely to undergo SLNB (OR = 0.05; 95% CI: 0.01-0.17; p < 0.001) compared to those in stage I. Those submitted to mastectomy had 90% less odds of submitting to SLNB than those submitted to conservative surgery (95% CI: 0.06-0.17; p < 0.001). Considering NAC responses, cases without response or with disease progression had a 55% lower chance of undergoing SLNB compared to those who had a complete response (OR = 0.45; 95% CI: 0.24-0.82; p = 0.009). Conclusion: SLNB was performed in 29% of patients after NAC. Patients who had a more advanced clinical stage of the disease, with a worse response to NAC and those who underwent mastectomies were less likely to undergo SLNB.
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