Table 4.
Adjustment of subsequent nonsurgical treatment in patients with a higher N class after the complementary ALND following discordant FS results of SLNs (n = 7)
| Patient (No.) | Age (y) | Definitive N stage after ALND | Tumor characteristics | Proposed postsurgical treatment after first operation (SNB and FS) | Definitive treatment after second operation (ALND) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Tumor size (cm) | HER2/neu | ER/PR | BR grade | RT | CT (Y/N) | HT (Y/N) | Treatment adjustment? | |||
| 1 | 77 | N1mi → N1a | 4.8 | – | −/− | 3 | No | No | No | No |
| 2 | 43 | N1mi → N1a | 2.3 | – | −/− | 2 | loco | Yes | No | No |
| 3 | 62 | N1mi → N1a | 6 | – | +/+ | 1 | prot | Yes | Yes | No |
| 4 | 57 | N1a → N2a | 2.1 | U | +/− | 1 | No | Yes | Yes | Yes, loco RT |
| 5 | 46 | N1a → N2a | 2.2 | – | +/− | 1 | No | Yes | Yes | Yes, loco RT |
| 6 | 75 | N1a → N2a | 1.1 | – | +/+ | 2 | No | No | Yes | Yes, loco RT |
| 7 | 49 | N1a → N2a | 2.1 | – | +/+ | 1 | prot | Yes | Yes | Yes, loco RT |
SNB sentinel node biopsy, FS frozen section, ALND axillary lymph node dissection, RT radiotherapy, loco locoregional, prot according to protocol, CT chemotherapy, HT hormonal therapy, BR Bloom-Richardson grade, ER/PR estrogen–progesterone receptor status, U unknown