BACKGROUND: Primary systemic chemotherapy has been a standard of care for the management of @entity0 ( @entity0 ) @entity1 and has increasingly been used for @entity1 with large operable @entity0 . Pathologic complete response (pCR) of axillary lymph node @entity3 predicted an excellent probability of long-term disease-free and overall survival. Although the clinical significance of occult lymph node @entity3 in @entity1 with @entity0 was extensively studied, their prognostic value in @entity1 with @entity0 after primary chemotherapy was not known. This study evaluated the detection rate and clinical significance of occult lymph node @entity3 in lymph nodes that contained @entity189 at the time of initial diagnosis and converted to negative based on routine pathologic examination after primary systemic chemotherapy. METHODS: Fifty-one @entity1 with @entity0 and cytologically involved axillary lymph nodes that converted to negative after preoperative chemotherapy were identified from 2 prospective clinical trials. All lymph node sections were reviewed, 1 deeper level @entity1710 and @entity1711 -stained section of each lymph node was obtained and immunohistochemical staining for cytokeratin (CK) was performed. A total of 762 lymph nodes were evaluated for occult @entity3 . Kaplan-Meier survival curves were used for calculating disease-free and overall survival times. RESULTS: Occult axillary lymph node @entity3 were identified in 8 of 51 (16%) @entity1 . In 6 @entity1 , occult @entity3 were found in only 1 lymph node. In 7 @entity1 , only isolated CK-positive cells were identified. In all cases, @entity189 cells were embedded within areas of @entity82 , foreign body giant cell reaction, and extensive @entity22964 . @entity1 with occult lymph node @entity3 tended to have a higher frequency of residual primary @entity0 than those without occult @entity3 (4 of 8 vs 7 of 43, respectively). There was no statistically significant difference in disease-free or overall survival times between @entity1 with and without occult @entity3 after a median follow-up 63 months. CONCLUSIONS: Persistent occult axillary lymph node @entity3 were not uncommon in @entity1 with axillary lymph node-positive @entity0 who experienced a pCR in involved lymph nodes after preoperative chemotherapy. However, such occult @entity3 did not adversely affect the good prognosis associated with axillary lymph node pCR. Therefore, routine lymph node CK evaluation was not recommended after primary chemotherapy.

Prognostic significance of occult axillary lymph node @entity3 after chemotherapy-induced pathologic complete response of cytologically proven axillary lymph node @entity3 from XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity82 :: ('MESH:D005355', 'Disease') :: ['fibrosis'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer', 'breast tumors', 'locally advanced breast cancer', 'LABC'] @entity22964 :: ('MESH:D015614', 'Disease') :: ['histiocytosis'] @entity1711 :: ('MESH:D004801', 'Chemical') :: ['eosin'] @entity189 :: ('MESH:D002277', 'Disease') :: ['occult carcinoma', 'metastatic carcinoma'] @entity1710 :: ('MESH:D006416', 'Chemical') :: ['hematoxylin'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
