KEY TAKEAWAYS
- The study aimed to investigate preoperative variables that may influence the omission of SLNB in patients with early breast cancer.
- Researchers found that risk stratification could identify patients suitable for omitting SLN biopsy, optimizing healthcare resources.
The SOUND study demonstrated that axillary de-escalation may be sufficient for locoregional and distant disease control in patients with selected early breast cancer (EBC). Building on this, the SOFT 1.23 study was planned to identify preoperative variables that might guide the omission of sentinel lymph node biopsy (SLNB).
Gianluca Vanni and the team aimed to determine which factors can predict the successful omission of SLNB while maintaining effective disease control. By refining patient selection through multifactorial risk stratification, they aimed to optimize the use of healthcare resources.
They performed an inclusive analysis of a single-center, retrospective study using a prospectively maintained database to identify preoperative prognostic factors associated with sentinel lymph node (SLN) metastasis.
This study compared patients with lymph node involvement (LN+) to those with negative lymph nodes (LN-). Secondary outcomes involved analyzing surgical room occupancy for patients with SLNB in meeting the SOUND study inclusion criteria. The study was approved by the institutional ethical committee Area Territoriale Lazio 2 (n° 122/23).
About 160 patients were included in the study between 1 January 2022 and 30 June 2023, with 26% classified in the LN+ group. The LN+ group exhibited multifocality, higher cT stage, and larger tumor diameter (P = 0.020, P = 0.014, and P = 0.016, respectively).
Tumor biology factors, such as estrogen and progesterone receptors and molecular subtypes, were also associated with the LN+ group (P < 0.001; P = 0.001; and P = 0.001, respectively). Among the patients, 117 (73.6%) met the SOUND study eligibility criteria, potentially saving 2696.81 minutes of operating room time.
The study concluded that de-escalating strategies could optimize healthcare activities by identifying patients who may benefit from SLNB omission.
This study received no external funding.
Source: https://pubmed.ncbi.nlm.nih.gov/39195292/
Vanni G, Materazzo M, Paduano F, et al. (2024). “New Insight for Axillary De-Escalation in Breast Cancer Surgery: “SoFT Study” Retrospective Analysis.” Curr Oncol. 2024;31(8):4141-4157. Published 2024 Jul 23. doi:10.3390/curroncol31080309
