ObjectiveTo investigate the effect of extranodal extension of axillary lymph nodes on the prognosis of triple-negative breast cancer (TNBC). MethodsThe TNBC patients with axillary lymph node metastasis admitted to the Nanyang Central Hospital from January 2017 to January 2019 were collected, and the patients were assigned into a negative soft tissue group and positive soft tissue group according to the status of soft tissue of external lymph node. The clinicopathologic characteristics and prognosis of the two groups were compared, and the factors affecting the prognosis were analyzed. ResultsA total of 216 patients were included, 123 and 93 of whom were in the negative soft tissue group and positive soft tissue group, respectively. Compared with the patients in the negative soft tissue group, the patients in the positive soft tissue group had a higher proportion of higher histological grade (grade Ⅲ), more number of metastatic lymph node (10 or more), and greater tumor diameter (5 cm or more), P<0.05. The 5-year cumulative disease-free survival (DFS) rate of the negative soft tissue group was higher than that of the positive soft tissue group (83.3% vs. 70.2%, χ2=? , P=0.008). The 5-year cumulative overall survival (OS) rate had no statistically significant difference between the the negative soft tissue group and positive soft tissue group (82.1% vs. 75.3%, χ2=? , P=0.161). The results of multivariate analysis showed that the higher histological grade (grade Ⅲ) and extranodal extension of axillary lymph nodes were the risk factors affecting the OS and DFS of the TNBC patients (P<0.05). It was also found that the number of metastatic lymph nodes (10 or more) and higher HER-2 expression were the risk factors affecting the OS of the TNBC patients (P<0.05), but which were not related to the DFS of the TNBC patients (P>0.05). ConclusionThe prognosis of TNBA patients with extranodal extension of axillary lymph nodes is worse, especially those with histological grade Ⅲ, lymph node metastasis number >10, and higher HER-2 expression.
ObjectiveTo summarize recent research on the surgical treatment of breast cancer after neoadjuvant chemotherapy (NAC) and to review the impact of NAC on the surgical treatment of breast cancer. MethodRelevant studies on NAC and surgical treatment of breast cancer from both domestic and international sources were reviewed. The literatures were analyzed, summarized, and discussed. ResultsFollowing NAC, the survival outcomes and risk of local recurrence in patients undergoing breast-conserving surgery were similar to those undergoing mastectomy. The using of image-guided minimally invasive biopsy accurately predicted pathological complete remission (pCR) of breast lesions after NAC, potentially allowed some breast cancer patients to undergo only radiation therapy after NAC, thus avoiding breast surgery. For patients with positive axillary lymph nodes, techniques such as dual-tracer, triple-tracer, and targeted axillary lymph node dissection had achieved clinical requirements in terms of detection rate and false-negative rate of sentinel lymph node biopsy, provided a safe alternative to axillary lymph node dissection. ConclusionsNAC is an important component of comprehensive breast cancer treatment. However, there is still controversy regarding the local treatment of the primary breast lesion and axillary lymph nodes after NAC. Currently, individualized treatment based on the specific circumstances of the patient remains the approach in clinical practice, aiming to achieve the optimal control of local recurrence and survival benefits for patients.