ArticleBreast cancer research and treatment2020
Axillary lymph node dissection in node-positive breast cancer: are ten nodes adequate and when is enough, enough?
Article in Breast cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 46 citations in OpenAlex.
- Nodal Pathologic Response After Neoadjuvant Systemic Therapy in Clinically Advanced Node-Positive (cN2 and cN3) Breast Cancer.Annals of surgical oncology · 2026Article
- Locally advanced breast cancer is the number of dissected nodes after neoadjuvant chemotherapy important?Ecancermedicalscience · 2026Review
- Locoregional Recurrence-Free Survival in Postmastectomy Breast Cancer: A Comparative Longitudinal Study of Hypofractionated Versus Conventional Fractionated Radiation Therapy.Indian journal of surgical oncology · 2025Article
- Construction and validation of a novel nomogram for prediction of lymph node metastasis in HER2-positive breast cancer: based on the optimal number of examined lymph nodes for accurate nodal staging.BMC women's health · 2025Article
- Algorithm-based analysis of lymph node dissection strategies and survival outcomes in primary oral squamous cell carcinoma.Frontiers in oncology · 2025Article
- Association of Breast Cancer Subtypes and Clinicopathological Factors with Axillary Lymph Node Positivity Amongst Women with Breast Cancer in Rajasthan: An Observational Analytical Study.Indian journal of surgical oncology · 2024Article
- Omission of Axillary Lymph Node Dissection in Patients with Residual Nodal Disease After Neoadjuvant Chemotherapy.Annals of surgical oncology · 2024Article
- American College of Surgeons Operative Standards and Breast Cancer Outcomes.JAMA network open · 2024Article
- Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla.American journal of surgery · 2024Article
- Article
- Comparison of survival outcomes between axillary conservation and axillary lymph node dissections in N1 early breast cancer: a propensity-matched SEER analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023Article
- Immediate lymph node extraction improves retrieval rate following axillary lymph node dissection: an effective approach to improving guideline-concordant breast cancer care in Nigeria.Ecancermedicalscience · 2023Article
- Is Pathologic Axillary Staging Valid If Lymph Nodes Are Less than 10 with Axillary Lymph Node Dissection after Neoadjuvant Chemotherapy?Journal of clinical medicine · 2022Article
- Characterization of surface markers on extracellular vesicles isolated from lymphatic exudate from patients with breast cancer.BMC cancer · 2022Article
- The prognostic role of lymph node ratio in breast cancer patients received neoadjuvant chemotherapy: A dose-response meta-analysis.Frontiers in surgery · 2022Review
- Extent of axillary surgery in inflammatory breast cancer: a survival analysis of 3500 patients.Breast cancer research and treatment · 2020Article
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7 authors at 1 institution in 1 country.
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Abstract
purposeNational guidelines define adequate axillary lymph node dissections as those yielding ≥ 10 lymph nodes (LNs). We aimed to identify the optimal LN yield among node-positive patients.
methodsUsing the National Cancer Data Base (2010-2015), we categorized node-positive patients as follows: (1) neoadjuvant chemotherapy (NAC, cN1-3 or ypN1mi-3) or (2) upfront surgery (pN1-3). A restricted cubic splines model was used to estimate LN retrieval thresholds associated with change in overall survival (OS).
results129,685 patients were identified: 21.2% NAC, 78.8% upfront surgery. Low, moderate, and high retrieval thresholds were estimated to be 1-6, 7-21, and > 21 LNs (upfront surgery), and 1-7, 8-22, and > 22 LNs (NAC). In an adjusted model, high versus low LN yield was associated with greater receipt of adjuvant chemotherapy (upfront surgery OR 1.96, p < 0.001) and greater use of adjuvant radiation (upfront surgery OR 1.08, p = 0.02; NAC OR 1.23, p = 0.002). After adjustment, high versus low LN retrieval was associated with improved OS (upfront surgery HR 0.86, p < 0.001; NAC HR 0.77, p < 0.001). Worse OS was associated with retrieving fewer LNs, likely as a result of an under-staged axilla and missed opportunity for adjuvant therapy, while better OS was independently associated with retrieval of up to approximately 20 LNs, after which survival did not improve.
conclusionIn node-positive breast cancer, the number of nodes retrieved is significantly associated with an increased positive nodal count and greater use of adjuvant therapy. Removal of approximately 20 LNs may improve survival by both more accurate nodal staging and increased adjuvant therapy use.
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