# Locally advanced breast cancer is the number of dissected nodes after neoadjuvant chemotherapy important?

## TL;DR

This study investigates whether the number of lymph nodes removed after chemotherapy affects survival in breast cancer patients.

## Contribution

The study provides evidence that the number of dissected lymph nodes does not impact survival outcomes in breast cancer patients after chemotherapy.

## Key findings

- Patients with ≥10 lymph nodes dissected had higher overall survival but no statistical significance.
- There was no difference in disease-free survival between groups.
- The number of nodes removed is not linked to relapse risk or survival probability.

## Abstract

To assess whether the number of lymph nodes (LN) in breast cancer (BC) patients undergoing axillary dissection (AD) after neoadjuvant chemotherapy affects disease-free survival (DFS) and overall survival (OS).

Descriptive, retrospective, longitudinal cut-off study (2011–2020).

391 patients, 176 patients in the <10 LNs group and 215 ≥10 dissected LGs. The mean number of dissected nodes was 6.2 and 13.8 in the < or ≥ 10 LN groups, respectively. The <10 LN group had a higher proportion of stage IIIB (p = 0.012) and ypN0 (p = 0.001) patients and higher frequency in the phenotypes: luminal A 23.5%, TN 24.1% and HER 2 18.7% when compared with patients with ≥10 LN. Patients with ≥10 LN retrieved had a higher mean OS compared to the group of patients <10 LN with no statistical association (p = 0.184) (hazard ratio = 1.91 95% CI: 0.73–4.98) and a survival probability at 120 months (both groups) of 96.2%. There was also no statistical difference in the DFS when comparing the two groups of patients, indicating that the number of nodes removed is not associated with a differential risk of relapse, with a survival probability at 120 months of 63.3%.

The results of the study indicate that the number of nodes removed during AD does not affect survival (OS and EFS) in patients with neoadjuvant (ypN0/ypN+) BC. Axillary staging remains a key factor in the management of BC; therefore, an individualised approach considering the response to triple negative breast cancer and tumour burden in therapeutic decision making is recommended.