用于治疗激素受体阳性乳腺癌 (HR BC) 的新辅助内分泌治疗 (NET) 的腋窝反应尚未得到充分描述。本研究旨在描述 NET 后的淋巴结反应特征。前瞻性收集的登记中纳入了 1998 年至 2022 年在综合癌症中心接受 NET 并随后接受根治性手术的患者。排除远处转移的患者。主要结局是淋巴结病理完全缓解（pCR）。降期被定义为 NET 后类别减少。我们纳入了 123 名患者；大多数是 cT2 (n = 59) 或 cT3 (n = 35) 和 cN0 (n = 81)。中位年龄为 70.0 岁（四分位数范围 62.1-76.0）。 42 名患者 (34.1%) 临床淋巴结阳性。 NET 后，73 人（59.8%）接受了保乳手术。所有患者均接受前哨淋巴结活检，其中 12 例（9.8%）接受完整腋窝淋巴结清扫术。 51 名 (41.5%) 患者实现了乳腺降期，其中 1 名 (0.8%) 患者获得了乳腺 pCR，14 名 (11.4%) 患者获得了乳腺升期。 10 例 (23.8%) 患者实现腋窝降期，6 例 (14.3%) 患者实现淋巴结 pCR，14 例 (33.3%) 患者出现腋窝升期。 10 年随访时，局部复发率为 1%，远处复发率为 14%，无病生存率为 82%。调整人口和临床因素后，年龄是与死亡率相关的唯一特征（风险比 1.07，95% 置信区间 1.01-1.13）。在接受 NET 治疗的 HR BC 中，尽管淋巴结 pCR，但长期无病生存率良好对于 cN 患者来说并不常见。需要未来的研究来阐明最佳的新辅助全身治疗，并制定肿瘤学安全策略，以减少残留微观疾病的腋窝治疗。© 2024。外科肿瘤学会。

Axillary response to neoadjuvant endocrine therapy (NET) for the treatment of hormone receptor-positive breast cancer (HR+ BC) is not well-described. This study was designed to characterize nodal response after NET.Patients receiving NET followed by curative intent surgery at a comprehensive cancer center from 1998 to 2022 in a prospectively collected registry were included. Patients with distant metastasis were excluded. Primary outcome was nodal pathologic complete response (pCR). Downstaging was defined as post-NET decrease in category.We included 123 patients; the majority were cT2 (n = 59) or cT3 (n = 35), and cN0 (n = 81). Median age was 70.0 years (interquartile range 62.1-76.0). Forty-two patients (34.1%) were clinically node-positive. After NET, 73 (59.8%) underwent breast-conserving surgery. All patients underwent sentinel lymph node biopsy, and 12 (9.8%) underwent completion axillary lymph node dissection. In-breast downstaging was achieved in 51 (41.5%) patients, 1 (0.8%) had breast pCR, and 14 (11.4%) had breast upstaging. Axillary downstaging was achieved in 10 (23.8%), 6 patients (14.3%) had nodal pCR, and 14 (33.3%) had axillary upstaging. At 10-year follow-up, local recurrence was 1% and distant recurrence was 14%, while disease-free survival was 82%. After adjusting for demographic and clinical factors, age was the only characteristic associated with mortality (hazard ratio 1.07, 95% confidence interval 1.01-1.13).In HR+ BC treated with NET, long-term disease-free survival is good, although nodal pCR is uncommon for cN+ patients. Future studies are needed to elucidate optimal neoadjuvant systemic therapy and to delineate oncologically safe strategies to deescalate axillary management for residual microscopic disease.© 2024. Society of Surgical Oncology.