Browsing by Author "Purkalne, Gunta"
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Item Chromothripsis and progression-free survival in metastatic colorectal cancer(2017-02) Skuja, Elina; Kalniete, Dagnija; Nakazawa-Miklaševiča, Miki; Daneberga, Zanda; Abolins, Arnis; Purkalne, Gunta; Miklasevics, Edvins; Onkoloģijas institūtsMetastatic dissemination of the primary tumor is the major cause of death in colorectal cancer (CRC) patients. Multiple chromosomal breaks and chromothripsis, a phenomenon involving multiple chromosomal fragmentations occurring in a single catastrophic event, are associated with cancer genesis, progression and developing of metastases. The aim of this study was to evaluate the effect of chromothripsis and total breakpoint count (breakpoint instability index) on progression-free survival (PFS). A total of 19 patients with metastatic CRC (mCRC) receiving FOLFOX first‑line palliative chemotherapy between August, 2011 and October, 2012 were selected for this study. The results indicated that the highest breakpoint count was observed in chromosomes 1, 2 and 6. Chromothripsis was detected in 52.6% of the study patients. Furthermore, chromothripsis was associated with an increased median PFS (mPFS; 14 vs. 8 months, respectively; P=0.03), but an association with overall survival was not identified. The present study demonstrated that chromothripsis affected CRC patient survival, suggesting a role for this event as a prognostic and predictive marker in mCRC treatment.Item Discussion on the use of taxanes for treatment of breast cancers in BRCA1 mutations carriers(2007-09-15) Irmejs, Arvids; Purkalne, Gunta; Bitina, Marianna; Gardovskis, Andris; Gardovskis, Janis; Onkoloģijas institūtsItem Erlotinib as single agent first line treatment in locally advanced or metastatic activating EGFR mutation-positive lung adenocarcinoma (CEETAC) : An open-label, non-randomized, multicenter, phase IV clinical trial(2018-05-25) Markóczy, Zsolt; Sárosi, Veronika; Kudaba, Iveta; Gálffy, Gabriella; Turay, Ülkü Yilmaz; Demirkazik, Ahmet; Purkalne, Gunta; Somfay, Attila; Pápai-Székely, Zsolt; Rásó, Erzsébet; Ostoros, Gyula; Onkoloģijas institūtsBackground: Erlotinib is approved for the first line treatment of epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer. Since the number of prospective studies in Caucasian patients treated in routine clinical setting is limited we conducted a multicenter, phase IV clinical trial to determine the efficacy and safety of erlotinib and to demonstrate the feasibility of the validated standardized companion diagnostic method of EGFR mutation detection. Methods: 651 chemonaive, cytologically or histologically verified advanced stage lung adenocarcinoma patients from Hungary, Turkey and Latvia were screened for exon19 microdeletions and exon21 L858R EGFR mutations using the companion diagnostic EGFR test. EGFR mutation-positive, locally advanced or metastatic lung adenocarcinoma patients received as first line treatment erlotinib at 150 mg/day. The primary endpoint was progression-free survival (PFS). Results: 62 EGFR mutation-positive patients (9.5% of screened) were included in the safety/intent-to-treat cohort. Median PFS was 12.8 months (95%CI, 9.9-15.8), objective response rate and one-year survival was 66.1% and 82.5%, respectively. Most frequent treatment related adverse events were diarrhoea and rash. Eastern Oncology Cooperative Group Performance Status (ECOG PS), smoking status and M1a/M1b disease stage were significant prognosticators of PFS (p = 0.017, p = 0.045 and p = 0.002, respectively). There was no significant difference in PFS between the subgroups stratified by gender, age or exon19 vs exon21 mutation. Conclusions: Our study confirmed the efficacy and safety of first line erlotinib monotherapy in Caucasian patients with locally advanced or metastatic lung adenocarcinoma carrying activating EGFR mutations based on the screening with the approved companion diagnostic procedure.Item Genotype-phenotype correlations among BRCA1 4153delA and 5382insC mutation carriers from Latvia(2011-10-27) Plakhins, Grigorijs; Irmejs, Arvids; Gardovskis, Andris; Subatniece, Signe; Rozite, Santa; Bitina, Marianna; Keire, Guntars; Purkalne, Gunta; Teibe, Uldis; Trofimovics, Genadijs; Miklasevics, Edvins; Gardovskis, Janis; Pārmantotā vēža pētniecības nodaļaBackground: Mutations in the high penetrance breast and ovarian cancer susceptibility gene BRCA1 account for a significant percentage of hereditary breast and ovarian cancer cases. Genotype-phenotype correlations of BRCA1 mutations located in different parts of the BRCA1 gene have been described previously; however, phenotypic differences of specific BRCA1 mutations have not yet been fully investigated. In our study, based on the analysis of a population-based series of unselected breast and ovarian cancer cases in Latvia, we show some aspects of the genotype-phenotype correlation among the BRCA1 c.4034delA (4153delA) and c.5266dupC (5382insC) founder mutation carriers.Methods: We investigated the prevalence of the BRCA1 founder mutations c.4034delA and c.5266dupC in a population-based series of unselected breast (n = 2546) and ovarian (n = 795) cancer cases. Among the BRCA1 mutation carriers identified in this analysis we compared the overall survival, age at diagnosis and family histories of breast and ovarian cancers.Results: We have found that the prevalence of breast and ovarian cancer cases (breast: ovarian cancer ratio) differs significantly among the carriers of the c.5266dupC and c.4034delA founder mutations (OR = 2.98, 95%CI = 1.58 to 5.62, P < 0.001). We have also found a difference in the prevalence of breast and ovarian cancer cases among the 1st and 2nd degree relatives of the c.4034delA and c.5266dupC mutation carriers. In addition, among the breast cancer cases the c.4034delA mutation has been associated with a later age of onset and worse clinical outcomes in comparison with the c.5266dupC mutation.Conclusions: Our data suggest that the carriers of the c.4034delA and c.5266dupC founder mutations have different risks of breast and ovarian cancer development, different age of onset and prognosis of breast cancer.Item Metastatic Colorectal Cancer Clinical and Genetic Prognostic and Predictive Factors. Summary of the Doctoral Thesis(Rīga Stradiņš University, 2020) Sīviņa, Elīna; Miklaševičs, Edvīns; Purkalne, GuntaColorectal cancer is one of the most common cancer types in the world. Although the results of early colorectal cancer treatment have improved significantly in recent decades, no effective therapy is currently available for advanced or metastatic disease. From a genetic standpoint, colorectal cancer is not a single disease, but a heterogeneous group of malignancies arising within the colon. Prognosis of mCRC is determined by oncogenetic pathway, localization of the primary tumour, molecular genetics of cancer, microenvironment and tumour stroma, and host microbiome. The progress in clinical and molecular studies have determined mechanisms of development and progression of colorectal cancer, and also helped to define most effective treatment strategy for each patent to prolong survival. Aim of the study was to demonstrate that both the clinical factors and chromosomal aberrations can be used as a prognostic and predictive factors in patients with metastatic colorectal cancer. Methods. The promotion work consists of three separate studies. In the first study, clinical factors (age, year of diagnosis, type of chemotherapy and number of treatment lines, localization of metastases) and their impact on progression free survival (PFS) and overall survival (OS) were analysed. 220 mCRC patients who received chemotherapy between 2004 and 2016 in P.Stradins CUH Clinic of Oncology (PSCUH) were included in retrospective study. In the second, prospective study, the impact of clinical factors – such as neutropenia and duration of previous treatment – on progression free survival in 14 patients with refractory mCRC receiving trifluridine/tipiracil (FTD/TPI) from April 2016 to January 2017 in PSCUH and RECUH/LOC were analysed. In the third, prospective study, impact of massive chromosomal fragmentation chromothripsis on progression free survival in 19 mCRC patients receiving first line FOLFOX chemotherapy in 2011–2012 were analysed. Results. The results of our study revealed that treatment strategy and survival of patients with unresectable mCRC is equal to data from published clinical studies. There was no significant difference in survival between synchronous and metachronous mCRC. Improved overall survival (OS) was observed in patients receiving more than one line of chemotherapy (HR 0.49; p = 0.0002), and in patient < 50 years (HR 0.49; p = 0.0002), but decreased OS was observed in patients with multiple metastases (p = 0.059). In patients with refractory mCRC receiving FTD/TPI treatment, two positive clinical predictive markers were identified – neutropenia and duration of previous treatment > 18 months. Increased mPFS (HR 0.24; p = 0.033) and mOS (HR 0.25; p = 0.075) was observed in patients with Grade 3 and 4 neutropenia. Similarly, increased mPFS (HR 0.15; p = 0.029) and mOS (HR 0.23; p = 0.069) was observed in patients with duration of previous treatment > 18 months. High breakpoint instability index (BPI) and chromothripsis are positive predictive markers in mCRC patients receiving first line FOLFOX chemotherapy. In patients without chromothripsis, mPFS was decreased (HR 3.43; p = 0.03), but the impact on OS was not detected. Conclusion. Different clinical and genetic factors may be used as a predictive and prognostic markers in treatment of mCRC.Item Metastātiska kolorektālā vēža klīniskie un ģenētiskie prognostiskie un prediktīvie marķieri. Promocijas darba kopsavilkums(Rīgas Stradiņa universitāte, 2020) Sīviņa, Elīna; Miklaševičs, Edvīns; Purkalne, GuntaKolorektālais vēzis ir viens no izplatītākajiem audzējiem pasaulē. Lai arī agrīna kolorektālā vēža ārstēšanas rezultāti pēdējās desmitgadēs ir ievērojami uzlabojušies, aizvien vēl nav pieejama efektīva metastātiska kolorektālā vēža (mKRV) ārstēšana. Ir arvien vairāk pierādījumu, ka kolorektālais vēzis ir ģenētiski heterogēna audzēju grupa, kurus vieno anatomiskā lokalizācija resnajā zarnā. Slimības agresivitāti un prognozi nosaka gan kolorektālā vēža rašanās onkoģenēzes ceļš, gan audzēja lokalizācija, izplatība, molekulāri ģenētiskās izmaiņas, audzēja mikrovide un stroma, kā arī zarnas mikrobioms. Izprotot kolorektālā vēža rašanās un progresēšanas mehānismus, mums ir iespēja precīzāk piemeklēt katram pacientam atbilstošu ārstēšanas veidu un pagarināt dzīvildzi. Darba mērķis. Pētījuma mērķis bija pierādīt, ka audzēja klīniskos rādītājus un audzēja hromosomālās izmaiņas var izmantot kā prognostiskus un prediktīvus faktorus pacientiem ar metastātisku kolorektālo vēzi (mKRV). Darba metodes. Lai sasniegtu mērķi, promocijas darbs tika sadalīts trīs daļās. Pirmajā pētījuma daļā tika analizēti mKRV pacientu klīniskie un demogrāfiskie rādītāji (vecums, slimības diagnosticēšanas gads, ķīmijterapijas veids un terapijas līniju skaits, metastāžu lokalizācija) un to ietekme uz bezprogresijas un kopējo izdzīvotību. Retrospektīvajā analīzē iekļauti 220 pacienti ar mKRV, kas saņēma ķīmijterapiju laika posmā no 2004. līdz 2016.gadam. Otrajā, prospektīvajā, pētījuma daļā tika analizēta divu klīnisko parametru – neitropēnija un laika intervāls līdz trešās līnijas ķīmijterapijas uzsākšanai – ietekme uz bezprogresijas izdzīvotību 14 pacientiem ar refraktāru mKRV, kuri saņēma trifluridīna/tipiracila (FTD/TPI) terapiju laika posmā no 2016. gada aprīļa līdz 2017. gada janvārim PSKUS un RAKUS/LOC. Trešajā, prospektīvajā, pētījuma daļā tika analizētas masīvas hromosomālās fragmentācijas (chromothripsis) ietekme uz bezprogresijas izdzīvotību mKRV pacientiem, kas saņēma pirmās līnijas ķīmijterapiju ar FOLFOX laika posmā no 2011. gada līdz 2012. gadam, kā arī analizētas biežākās gēnu delēcijas. Darba rezultāti. Pētījuma rezultāti liecina, ka nerezecējama mKRV pacientu ārstēšana PSKUS un RAKUS/LOC un viņu izdzīvotība ir līdzīga publicēto pētījumu datiem. Netika konstatēta izdzīvotības atšķirība pacientiem ar sinhronu vai metahronu mKRV, bet ievērojami labāka kopējā izdzīvotība (OS) konstatēta pacientiem, kuri saņēma vairāk par vienu ķīmijterapijas līniju (HR 0,36; p < 0,0001), kā arī pacientiem, kas jaunāki par 50 gadiem (HR 0,49; p = 0,0002). Sliktāka kopējā izdzīvotība bija pacientiem ar multiplām metastāzēm (p = 0,059). Pacientiem ar refraktāru mKRV, kas saņēma FTD/TPI terapiju, konstatēti divi pozitīvi klīniskie prediktīvie marķieri – neitropēnija terapijas saņemšanas laikā un laiks no slimības diagnosticēšanas brīža līdz FTD/TPI uzsākšanai vairāk par 18 mēnešiem. Pagarināta mPFS (HR 0,24, p = 0,033) un mOS (HR 0,25; p = 0,075) konstatēta pacientiem ar 3. un 4. pakāpes neitropēniju. Līdzīgi, labāka mPFS (HR 0,15; p = 0,029) un mOS (HR 0,23; p = 0,069) konstatēta pacientiem ar iepriekšējās terapijas ilgumu vairāk par 18 mēnešiem. Augsts DNS lūzumpunktu nestabilitātes indekss (LNI) un chromothripsis ir pozitīvs prediktīvs marķieris mKRV pacientiem, kas saņēma paliatīvu pirmās līnijas FOLFOX tipa ķīmijterapiju. Pacientiem bez chromothripsis mPFS bija īsāka (HR 3,43; p = 0,03), bet netika konstatēta ietekme uz kopējo izdzīvotību. Secinājumi. Minētā atrade ļauj secināt, ka mKRV klīniskie un ģenētiskie faktori var tikt izmantoti, lai prognozētu terapijas efektivitāti un slimības gaitu.Item Metastātiska kolorektālā vēža klīniskie un ģenētiskie prognostiskie un prediktīvie marķieri. Promocijas darbs(Rīgas Stradiņa universitāte, 2020) Sīviņa, Elīna; Miklaševičs, Edvīns; Purkalne, GuntaKolorektālais vēzis ir viens no izplatītākajiem audzējiem pasaulē. Lai arī agrīna kolorektālā vēža ārstēšanas rezultāti pēdējās desmitgadēs ir ievērojami uzlabojušies, aizvien vēl nav pieejama efektīva metastātiska kolorektālā vēža (mKRV) ārstēšana. Ir arvien vairāk pierādījumu, ka kolorektālais vēzis ir ģenētiski heterogēna audzēju grupa, kurus vieno anatomiskā lokalizācija resnajā zarnā. Slimības agresivitāti un prognozi nosaka gan kolorektālā vēža rašanās onkoģenēzes ceļš, gan audzēja lokalizācija, izplatība, molekulāri ģenētiskās izmaiņas, audzēja mikrovide un stroma, kā arī zarnas mikrobioms. Izprotot kolorektālā vēža rašanās un progresēšanas mehānismus, mums ir iespēja precīzāk piemeklēt katram pacientam atbilstošu ārstēšanas veidu un pagarināt dzīvildzi. Darba mērķis. Pētījuma mērķis bija pierādīt, ka audzēja klīniskos rādītājus un audzēja hromosomālās izmaiņas var izmantot kā prognostiskus un prediktīvus faktorus pacientiem ar metastātisku kolorektālo vēzi (mKRV). Darba metodes. Lai sasniegtu mērķi, promocijas darbs tika sadalīts trīs daļās. Pirmajā pētījuma daļā tika analizēti mKRV pacientu klīniskie un demogrāfiskie rādītāji (vecums, slimības diagnosticēšanas gads, ķīmijterapijas veids un terapijas līniju skaits, metastāžu lokalizācija) un to ietekme uz bezprogresijas un kopējo izdzīvotību. Retrospektīvajā analīzē iekļauti 220 pacienti ar mKRV, kas saņēma ķīmijterapiju laika posmā no 2004. līdz 2016.gadam. Otrajā, prospektīvajā, pētījuma daļā tika analizēta divu klīnisko parametru – neitropēnija un laika intervāls līdz trešās līnijas ķīmijterapijas uzsākšanai – ietekme uz bezprogresijas izdzīvotību 14 pacientiem ar refraktāru mKRV, kuri saņēma trifluridīna/tipiracila (FTD/TPI) terapiju laika posmā no 2016. gada aprīļa līdz 2017. gada janvārim PSKUS un RAKUS/LOC. Trešajā, prospektīvajā, pētījuma daļā tika analizētas masīvas hromosomālās fragmentācijas (chromothripsis) ietekme uz bezprogresijas izdzīvotību mKRV pacientiem, kas saņēma pirmās līnijas ķīmijterapiju ar FOLFOX laika posmā no 2011. gada līdz 2012. gadam, kā arī analizētas biežākās gēnu delēcijas. Darba rezultāti. Pētījuma rezultāti liecina, ka nerezecējama mKRV pacientu ārstēšana PSKUS un RAKUS/LOC un viņu izdzīvotība ir līdzīga publicēto pētījumu datiem. Netika konstatēta izdzīvotības atšķirība pacientiem ar sinhronu vai metahronu mKRV, bet ievērojami labāka kopējā izdzīvotība (OS) konstatēta pacientiem, kuri saņēma vairāk par vienu ķīmijterapijas līniju (HR 0,36; p < 0,0001), kā arī pacientiem, kas jaunāki par 50 gadiem (HR 0,49; p = 0,0002). Sliktāka kopējā izdzīvotība bija pacientiem ar multiplām metastāzēm (p = 0,059). Pacientiem ar refraktāru mKRV, kas saņēma FTD/TPI terapiju, konstatēti divi pozitīvi klīniskie prediktīvie marķieri – neitropēnija terapijas saņemšanas laikā un laiks no slimības diagnosticēšanas brīža līdz FTD/TPI uzsākšanai vairāk par 18 mēnešiem. Pagarināta mPFS (HR 0,24, p = 0,033) un mOS (HR 0,25; p = 0,075) konstatēta pacientiem ar 3. un 4. pakāpes neitropēniju. Līdzīgi, labāka mPFS (HR 0,15; p = 0,029) un mOS (HR 0,23; p = 0,069) konstatēta pacientiem ar iepriekšējās terapijas ilgumu vairāk par 18 mēnešiem. Augsts DNS lūzumpunktu nestabilitātes indekss (LNI) un chromothripsis ir pozitīvs prediktīvs marķieris mKRV pacientiem, kas saņēma paliatīvu pirmās līnijas FOLFOX tipa ķīmijterapiju. Pacientiem bez chromothripsis mPFS bija īsāka (HR 3,43; p = 0,03), bet netika konstatēta ietekme uz kopējo izdzīvotību. Secinājumi. Minētā atrade ļauj secināt, ka mKRV klīniskie un ģenētiskie faktori var tikt izmantoti, lai prognozētu terapijas efektivitāti un slimības gaitu.Item Neoadjuvant Chemoradiation in Patient with Localy Advanced Rectal Cancer(2013-12-01) Skuja, Elina; Sorubalko, Arturs; Purkalne, Gunta; Miklasevics, Edvins; Onkoloģijas institūtsItem Neoadjuvant Chemoradiotherapy in the Downstaging of Locally Advanced Rectal Cancer and its Impact on Progression–Free Survival(2020-11-18) Neško, Tatjana; Neško, Arvils; Sīviņa, Elīna; Purkalne, Gunta; Rīga Stradiņš UniversityIntroduction. The standard treatment for locally advanced rectal cancer (LARC) is neoadjuvant chemoradiotherapy (NACRT) followed by radical surgery, which allows to reduce local recurrence, downsize the tumor and facilitate its R0 resection. Aim of the study. The aim of this study was to evaluate the downstaging of LARC after NACRT and to assess the impact of downstaging on progression–free survival (PFS). Materials and methods. 65 patients diagnosed with LARC from 2012 to 2018, who received NACRT with subsequent radical surgery were identified in the Pauls Stradins Clinical University Hospital in Riga and included in this retrospective study. Average follow–up period was 31 months. Data were analysed with SPSS Statistics 22.0, Wilcoxon signed–rank test and Kaplan–Meier survival analysis were performed. Results. Overall, 66.7% (n=40) of patients experienced a downstaging in response to NACRT, of which 37.5% (n=24, p=0.004) had a downstaging of T and 63.3% (n=38, p=0.0001) of N. 12–month PFS was 87.8%, 24–month PFS – 66.1% and 3–year PFS – 62.7%, median PFS (mPFS) was not met. 3–year PFS of those patients treated with intravenous 5FU/LV boluses was significantly higher (76.5%) than those who received oral tegafur (45.6%, mPFS 32 months), p=0.038. 3–year PFS of patients with downstaged T was 85.9%, compared to 52.1% without it; mPFS not met, p=0.04. Similarly, 3–year PFS of patients with downstaged N was 71.5%, compared to 43.3% without it (mPFS 24 months), p=0.112. Lymphatic and vascular invasion were associated with significantly lower PFS compared to the patients with absent lymphatic and vascular invasion (p=0.0001 and p=0.014, respectively), while perineural invasion did not show any impact on PFS. Age at diagnosis, tumor location, type of surgery and adjuvant chemotherapy did not have a significant impact on PFS. Conclusions. Results confirm the efficacy of NACRT in LARC in the downstaging of T and N. Downstaging of LARC, intravenous chemotherapy and absence of lymphovascular invasion are associated with significantly increased PFS.Item Pathological Complete Remission in Young Colon Cancer Patient with a Large Liver Metastasis after FOLFOX-4/Bevacizumab Treatment – A Case Report(2012-01-01) Skuja, Elīna; Āboliņš, Arnis; Priedīte, Ilze; Purkalne, Gunta; Štrumfa, Ilze; Vilmanis, Jānis; Kalniete, Dagnija; Miklaševičs, Edvīns; Gardovskis, Jānis; Onkoloģijas institūtsItem Platinum-based neoadjuvant chemotherapy in BRCA1-positive breast cancer : A retrospective cohort analysis and literature review(2018-04-27) Sæther, Nikolai Havn; Skuja, Elina; Irmejs, Arvids; Maksimenko, Jelena; Miklasevics, Edvins; Purkalne, Gunta; Gardovskis, Janis; Rīga Stradiņš UniversityBackground: There is increasing evidence of high platinum sensitivity in BRCA-associated breast cancer. However, evidence from randomized trials is lacking. The aim of this study was to analyze the results of platinum-based chemotherapy for BRCA1-positive breast cancer in a neoadjuvant setting. Methods: A retrospective study was performed by obtaining information from patient files. The results were compared with the available data from a literature review. Results: Twelve female patients with BRCA1 gene mutations who had stage I to III breast cancers were eligible for evaluation. They received platinum-based neoadjuvant chemotherapy between 2011 and 2016. Eleven patients received a combination of cisplatin and doxorubicin, and one patient received carboplatin and docetaxel. All patients underwent mastectomy after chemotherapy. Ten patients (83%) achieved pathological complete remission (pCR). The observed pCR rate was comparable to existing results found in similar studies. Conclusion: The results of the study confirm the high pCR rate in BRCA1-positive breast cancer after platinum-based neoadjuvant chemotherapy. Larger randomized studies and longer follow-up times are necessary to evaluate the role of platinum-based therapies in BRCA1-positive breast cancer.Item Role of percutaneous needle biopsy of axillary lymph nodes to evaluate node positive breast cancer after neoadjuvant chemotherapy(2019) Līcīte, Baiba; Irmejs, Arvīds; Maksimenko, Jeļena; Loža, Pēteris; Trofimovičs, Genadijs; Miklaševičs, Edvīns; Nazarovs, Jurijs; Romanovska, M.; Deičmane, J.; Purkalne, Gunta; Gardovskis, Jānis; Department of Surgery; Onkoloģijas institūtsItem Ultrasound guided needle biopsy of axilla to evaluate nodal metastasis after preoperative systemic therapy in cohort of 106 breast cancers enriched with BRCA1/2 pathogenic variant carriers(2021-07-07) Līcīte, Baiba; Irmejs, Arvīds; Maksimenko, Jeļena; Loža, Pēteris; Trofimovičs, Genādijs; Miklaševičs, Edvīns; Nazarovs, Jurijs; Romanovska, Māra; Deičmane, Justīne; Irmejs, Reinis; Purkalne, Gunta; Gardovskis, Jānis; Department of Surgery; Onkoloģijas institūtsBackground: Aim of the study is to evaluate the role of ultrasound guided fine needle aspiration cytology (FNAC) in the restaging of node positive breast cancer after preoperative systemic therapy (PST). Methods: From January 2016 – October 2020 106 node positive stage IIA-IIIC breast cancer cases undergoing PST were included in the study. 18 (17 %) were carriers of pathogenic variant in BRCA1/2. After PST restaging of axilla was performed with ultrasound and FNAC of the marked and/or the most suspicious axillary node. In 72/106 cases axilla conserving surgery and in 34/106 cases axillary lymph node dissection (ALND) was performed. Results: False Positive Rate (FPR) of FNAC after PST in whole cohort and BRCA1/2 positive subgroup is 8 and 0 % and False Negative Rate (FNR) – 43 and 18 % respectively. Overall Sensitivity − 55 %, specificity- 93 %, accuracy 70 %. Conclusion: FNAC after PST has low FPR and is useful to predict residual axillary disease and to streamline surgical decision making regarding ALND both in BRCA1/2 positive and negative subgroups. FNR is high in overall cohort and FNAC alone are not able to predict ypCR and omission of further axillary surgery. However, FNAC performance in BRCA1/2 positive subgroup is more promising and further research with larger number of cases is necessary to confirm the results.