Breast Conserving Surgery and Sentinel Lymph Node Biopsy in Locally Advanced Breast Cancer: Single Center Experience

Abstract

Objective: Patients with locally advanced breast cancer may undergo breast conserving surgery after neoadjuvant chemotherapy. The aim of the study is to evaluate the results of locally advanced breast cancer patients who underwent breast conserving surgery, axillary dissection and sentinel lymph node biopsy in a single center. Material and Methods: 12 patients with locally advanced breast cancer stage IIIA/IIIB were included in the study between 2002-2009. The patients were given anthracycline-based regimen before surgery. Patients underwent breast conserving surgery, axillary dissection, and sentinel lymph node biopsy followed by radiotherapy. Results: There were five patients in stage IIIA, six in stage IIIB, and one in stage IIIC. Patients had received 3-6 regimen of FAC/FEC. Eight had partial and four had complete response. Five positive axilla were detected. The median value of the lymph nodes was 12 (n:8-19). Five patients underwent sentinel lymph node biopsy. The biopsy has failed in one patient and the median value of dissected sentinel node was 3.5 (n:3-4). Locoregional recurrence was not observed in any patients. The mean follow-up of the patients was 29.8 months and median time was 16 (n:2-80) months. Of the 12 patients 10 are alive and 2 were deceased. Conclusion: In selected locally advanced patients, breast conserving surgery and sentinel lymph node biopsy may be applied by a multidisciplinary approach, and excellent success may be achieved in those patients as in early breast cancer patients. Amaç: Lokal ileri evre meme kanserinde neoadjuvan kemoterapi ile hastalar meme koruyucu cerrahi olma şansını yakalayabilmektedir. Bu yazıda lokal ileri evre meme kanseri nedeni neoadjuvan kemoterapi sonrası meme koruyucu cerrahi,aksiler diseksiyon ve sentinel lenf nodu örneklemesi yapılmış hastaların sonuçları değerlendirilmiştir. Gereç ve Yöntemler: Bu çalışmaya 2002-2009 yılları arasında evre IIIA ve IIIB lokal ileri evre meme kanserli 12 hasta alınmıştır. Hastalara cerrahi öncesi antrasiklin bazlı kemoterapi rejimleri uygulanmıştır. Level 2 aksiller lenf nodu diseksiyonu öncesi sentinel lenf nodu örneklemesi, meme koruyucu cerrahi ve sonrasında radyoterapi yapılmıştır. Bulgular: Hastaların beşi evre IIIA, altısı IIIB ve biri evre IIIB idi.Hastalara 3-6 kür arası FAC/FEC rejimleri uygulandı. 8 hastada kısmi, 4'ünde tam yanıt alındı. Aksiller diseksiyon yapılan hastaların 5'inde pozitif lenf nodu görüldü. Lenf nodu ortanca değeri 12 (n:8-19) idi. Beş hastaya sentinel lenf nodu örneklemesi yapıldı.Bir hastada sentinel lenf nodu görüntülenemedi. Diseke edilen sentinel lenf nodu ortanca değeri 3,5 (n:3-4) idi. Hiçbir hastada lokoregional nüks görülmedi. Hastaların ortalama takip süresi 29.8 ay olup, ortanca takip süresi 16 (2-80) ay olarak tespit edildi. 12 hastanın 10'u yaşamakta olup 2'si exitus oldu. Sonuç: Uygun hastalarda multidisipliner çalışma ile neoadjuvan kemoterapi sonrası lokal ileri evre meme kanserlerinde meme koruyucu cerrahi ve sentinel lenf nodu yapılabilinir ve erken evre meme kanserinde olduğu gibi kür sansı sağlanabilir.

Keywords

• Breast cancer, locally advanced stage, breast conserving surgery, sentinel lymph node biopsy

Lokal İleri Evre Meme Kanserlerinde Meme Koruyucu Cerrahi ve Sentinel Lenf Nodu Örneklemesi: Tek Merkez Deneyimi

Öz

Amaç: Lokal ileri evre meme kanserinde neoadjuvan kemoterapi ile hastalar meme koruyucu cerrahi olma şansını yakalayabilmektedir. Bu yazıda lokal ileri evre meme kanseri nedeni neoadjuvan kemoterapi sonrası meme koruyucu cerrahi,aksiler diseksiyon ve sentinel lenf nodu örneklemesi yapılmış hastaların sonuçları değerlendirilmiştir. Gereç ve Yöntemler: Bu çalışmaya 2002-2009 yılları arasında evre IIIA ve IIIB lokal ileri evre meme kanserli 12 hasta alınmıştır. Hastalara cerrahi öncesi antrasiklin bazlı kemoterapi rejimleri uygulanmıştır. Level 2 aksiller lenf nodu diseksiyonu öncesi sentinel lenf nodu örneklemesi, meme koruyucu cerrahi ve sonrasında radyoterapi yapılmıştır. Bulgular: Hastaların beşi evre IIIA, altısı IIIB ve biri evre IIIB idi.Hastalara 3-6 kür arası FAC/FEC rejimleri uygulandı. 8 hastada kısmi, 4’ünde tam yanıt alındı. Aksiller diseksiyon yapılan hastaların 5’inde pozitif lenf nodu görüldü. Lenf nodu ortanca değeri 12 (n:8-19) idi. Beş hastaya sentinel lenf nodu örneklemesi yapıldı.Bir hastada sentinel lenf nodu görüntülenemedi. Diseke edilen sentinel lenf nodu ortanca değeri 3,5 (n:3-4) idi. Hiçbir hastada lokoregional nüks görülmedi. Hastaların ortalama takip sü- resi 29.8 ay olup, ortanca takip süresi 16 (2-80) ay olarak tespit edildi. 12 hastanın 10’u yaşamakta olup 2’si exitus oldu. Sonuç: Uygun hastalarda multidisipliner çalışma ile neoadjuvan kemoterapi sonrası lokal ileri evre meme kanserlerinde meme koruyucu cerrahi ve sentinel lenf nodu yapılabilinir ve erken evre meme kanserinde olduğu gibi kür sansı sağlanabilir.

Anahtar Kelimeler

• Meme kanseri, lokal ileri evre, meme koruyucu cerrahi, sentinel lenf nodu örneklemesi

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