Trial reportAnnals of surgery2016
Identification and Resection of Clipped Node Decreases the False-negative Rate of Sentinel Lymph Node Surgery in Patients Presenting With Node-positive Breast Cancer (T0-T4, N1-N2) Who Receive Neoadjuvant Chemotherapy: Results From ACOSOG Z1071 (Alliance).
Trial report in Annals of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 186 papers, 10 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
186 citing papers in PubMed, 10 syntheses or guidelines pooled it, 444 citations in OpenAlex.
- Oncologic Outcomes of Sentinel Lymph Node Biopsy Versus Targeted Axillary Dissection for Node-Positive Breast Cancer Patients After Neoadjuvant Chemotherapy: A Systematic Review and Meta-Analysis.Annals of surgical oncology · 2026Pooled it
- Different strategies in de-escalation of axillary surgery in node-positive breast cancer following neoadjuvant treatment: a systematic review and meta-analysis of long-term outcomes.Breast cancer (Tokyo, Japan) · 2025Pooled it
- Systematic review of targeted axillary dissection in node-positive breast cancer treated with neoadjuvant systemic therapy: variation in type of marker and timing of placement.The British journal of surgery · 2024Pooled it
- Uncertainties and controversies in axillary management of patients with breast cancer.Cancer treatment reviews · 2023Pooled it
- Diagnostic accuracy of de-escalated surgical procedure in axilla for node-positive breast cancer patients treated with neoadjuvant systemic therapy: A systematic review and meta-analysis.Cancer medicine · 2022Pooled it
- False Negativity of Targeted Axillary Dissection in Breast Cancer.Breast care (Basel, Switzerland) · 2021Pooled it
- Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer 2021.Annals of oncology : official journal of the European Society for Medical Oncology · 2021Guideline
- Different strategies in marking axillary lymph nodes in breast cancer patients undergoing neoadjuvant medical treatment: a systematic review.Breast cancer research and treatment · 2021Pooled it
- Axillary ultrasound for prediction of response to neoadjuvant therapy in the context of surgical strategies to axillary dissection in primary breast cancer: a systematic review of the current literature.Archives of gynecology and obstetrics · 2020Pooled it
- Diagnostic Accuracy of Different Surgical Procedures for Axillary Staging After Neoadjuvant Systemic Therapy in Node-positive Breast Cancer: A Systematic Review and Meta-analysis.Annals of surgery · 2019Pooled it
- Axillary Management and Outcomes After Neoadjuvant Endocrine Therapy in the Randomized PELOPS Trial.Annals of surgical oncology · 2026Trial
- Diagnostic accuracy of sentinel lymph node biopsy and wire localized clipped node biopsy after neoadjuvant chemotherapy in node-positive breast cancer.Surgery today · 2025Trial
- Trial
- Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101).Breast (Edinburgh, Scotland) · 2021Trial
- Initial results of a novel technique of clipped node localization in breast cancer patients postneoadjuvant chemotherapy: Skin Mark clipped Axillary nodes Removal Technique (SMART trial).Cancer medicine · 2020Trial
- Axillary staging in breast cancer patients treated with neoadjuvant chemotherapy in two Dutch phase III studies.Oncotarget · 2017Trial
- Selective surgical localization of axillary lymph nodes containing metastases in patients with breast cancer: a prospective feasibility trial.JAMA surgery · 2015Trial
- Axillary treatment options in clinically nodes-positive breast cancer whose nodes become pathologically nodes-negative after neoadjuvant chemotherapy: a pairwise and network meta-analysis.Annals of medicine · 2026Article
- Timing of Surgical Axillary Staging and Impact on Technical Success of Immediate Lymphatic Reconstruction Following Axillary Lymph Node Dissection.Annals of surgical oncology · 2026Article
- Does Color Doppler Twinkling Change Between Ultrasound Platform Generations? - A Comparison Using Breast Biopsy Markers.Academic radiology · 2026Article
126 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe American College of Surgeons Oncology Group Z1071 trial reported a false-negative rate (FNR) of 12.6% with sentinel lymph node (SLN) surgery after neoadjuvant chemotherapy in women presenting with node-positive breast cancer. One proposed method to decrease the FNR is clip placement in the positive node at initial diagnosis with confirmation of clipped node resection at surgery.
methodsZ1071 was a multi-institutional trial wherein women with clinical T0-T4,N1-N2,M0 breast cancer underwent SLN surgery and axillary dissection (ALND) after neoadjuvant chemotherapy. In cases with a clip placed in the node, the clip location at surgery (SLN or ALND) was evaluated.
resultsA clip was placed at initial node biopsy in 203 patients. In the 170 (83.7%) patients with cN1 disease and at least 2 SLNs resected, clip location was confirmed in 141 cases. In 107 (75.9%) patients where the clipped node was within the SLN specimen, the FNR was 6.8% (confidence interval [CI]: 1.9%-16.5%). In 34 (24.1%) cases where the clipped node was in the ALND specimen, the FNR was 19.0% (CI: 5.4%-41.9%). In cases without a clip placed (n = 355) and in those where clipped node location was not confirmed at surgery (n = 29), the FNR was 13.4% and 14.3%, respectively.
conclusionsClip placement at diagnosis of node-positive disease with removal of the clipped node during SLN surgery reduces the FNR of SLN surgery after neoadjuvant chemotherapy. Clip placement in the biopsy-proven node at diagnosis and evaluation of resected specimens for the clipped node should be considered when conducting SLN surgery in this setting.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.