ArticleAnnals of surgical oncology2018
Is Low-Volume Disease in the Sentinel Node After Neoadjuvant Chemotherapy an Indication for Axillary Dissection?
Article in Annals of surgical oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 63 papers, 4 of them syntheses that pooled it.
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Who cites it
63 citing papers in PubMed, 4 syntheses or guidelines pooled it, 159 citations in OpenAlex.
- DEGRO practical guidelines: radiotherapy of breast cancer-regional nodal irradiation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Guideline
- 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
- Guideline
- 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
- Axillary Management and Outcomes After Neoadjuvant Endocrine Therapy in the Randomized PELOPS Trial.Annals of surgical oncology · 2026Trial
- Omitting Regional Nodal Irradiation after Response to Neoadjuvant Chemotherapy.The New England journal of medicine · 2025Trial
- Factors Associated with Omission of Axillary Lymph Node Dissection for Patients with Clinical Node-Positive Breast Cancer Who have Residual Nodal Disease on Pathology After Neoadjuvant Chemotherapy.Annals of surgical oncology · 2026Observational
- Article
- Impact of axillary disease extent defined by baselineBreast (Edinburgh, Scotland) · 2026Article
- Rapid intraoperative cytokeratin immunohistochemistry improves diagnostic accuracy of sentinel lymph nodes in post-neoadjuvant breast cancer.Virchows Archiv : an international journal of pathology · 2026Article
- Axillary Management in Breast Cancer Patients with Positive Lymph Nodes Following Neoadjuvant Chemotherapy.Annals of surgical oncology · 2026Article
- Prognostic value of metastatic lymph-node ratio and log-odds of positive nodes after neoadjuvant chemotherapy in breast cancer.World journal of surgical oncology · 2026Article
- Oncological outcomes with and without axillary lymph node dissection in patients with residual micrometastases after neoadjuvant chemotherapy (OPBC-07/microNAC): an international, retrospective cohort study.The Lancet. Oncology · 2026Article
- The Canadian Breast Cancer Symposium 2025: Meeting Report.Current oncology (Toronto, Ont.) · 2025Article
- Molecular subtype-driven disparities in intraoperative touch imprint cytology accuracy for sentinel lymph node assessment in clinically node-positive breast cancer treated with neoadjuvant chemotherapy.European journal of medical research · 2025Article
- Factors Predicting Additional Residual Nodal Disease With a Metastatic Sentinel Node Biopsy or Targeted Axillary Dissection After Neoadjuvant Chemotherapy.Journal of breast cancer · 2025Article
- BJS commission on the surgical management of the axilla in breast cancer.The British journal of surgery · 2025Article
- Therapy of early breast cancer: current status and perspectives.Archives of gynecology and obstetrics · 2025Review
- Oncologic Outcomes with De-Escalation of Axillary Surgery After Neoadjuvant Chemotherapy for Breast Cancer: Results from > 1500 Patients on the I-SPY2 Clinical Trial.Annals of surgical oncology · 2025Observational
- Optimizing management of sentinel lymph node limited residual tumor after neoadjuvant therapy for breast cancer: Balancing of act.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2025Article
3 more citing papers are in PubMed but not listed here.
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8 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND/
objectiveIntraoperative evaluation of sentinel lymph nodes (SLNs) after neoadjuvant chemotherapy (NAC) has a higher false-negative rate than in the primary surgical setting, particularly for small tumor deposits. Additional tumor burden seen with isolated tumor cells (ITCs) and micrometastases following primary surgery is low; however, it is unknown whether the same is true after NAC. We examined the false-negative rate of intraoperative frozen section (FS) after NAC, and the association between SLN metastasis size and residual disease at axillary lymph node dissection (ALND).
methodsPatients undergoing SLN biopsy after NAC were identified. The association between SLN metastasis size and residual axillary disease was examined.
resultsFrom July 2008 to July 2017, 702 patients (711 cancers) had SLN biopsy after NAC. On FS, 181 had metastases, 530 were negative; 33 negative cases were positive on final pathology (false-negative rate 6.2%). Among patients with a positive FS, 3 (2%) had ITCs and no further disease on ALND; 41 (23%) had micrometastases and 125 (69%) had macrometastases. Fifty-nine percent of patients with micrometastases and 63% with macrometastases had one or more additional positive nodes at ALND. Among those with a false-negative result, 10 (30%) had ITCs, 15 (46%) had micrometastases, and 8 (24%) had macrometastases; 17 had ALND and 59% had one or more additional positive lymph nodes. Overall, 1/6 (17%) patients with ITCs and 28/44 (64%) patients with micrometastases had additional nodal metastases at ALND.
conclusionLow-volume SLN disease after NAC is not an indicator of a low risk of additional positive axillary nodes and remains an indication for ALND, even when not detected on intraoperative FS.
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