ArticleAnnals of surgical oncology2020
Selecting Node-Positive Patients for Axillary Downstaging with Neoadjuvant Chemotherapy.
Article in Annals of surgical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 82 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
- 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
- Lack of Utility of Ki-67 in Axillary Surgical Planning and Prognostication after Neoadjuvant Chemotherapy for Node-Positive Breast Cancer.Annals of surgical oncology · 2026Article
- Multidisciplinary Management Considerations in Invasive Lobular Breast Cancer: It Isn't Just Ductal.Annals of surgical oncology · 2026Review
- Mammography-based artificial intelligence model for predicting axillary lymph node status after neoadjuvant therapy in breast cancer.European radiology · 2026Article
- Omission of axillary dissection in patients with microscopic residual nodal disease after neoadjuvant chemotherapy.Gland surgery · 2026Article
- Research on Omitting Sentinel Lymph Node Biopsy after Neoadjuvant Therapy in cN1 Breast Cancer Patients.Cancer medicine · 2026Article
- Role of Sentinel Lymph Node Biopsy with Blue Dye Only after Neoadjuvant Systemic Treatment in Patients with Breast Cancer Who Had Biopsy-Proven Node-Positive Disease at Admission: SENATURK-ROSANNA Study.Breast care (Basel, Switzerland) · 2026Article
- Sentinel lymph node biopsy with blue dye after neoadjuvant chemotherapy in initially node negative and positive breast cancer.World journal of surgical oncology · 2025Article
- Axillary management in the post-neoadjuvant setting: dual tracer vs. single tracer for sentinel lymph node biopsy.Updates in surgery · 2025Article
- Factors Associated With Residual Positive Lymph Nodes With Targeted Axillary Lymph Node Dissection for Breast Cancer and Accuracy of Clipped Node Retrieval in Non-Mapping Patients.Journal of surgical oncology · 2025Article
- Is There a Therapeutic Benefit of Axillary Surgery in Non-Metastatic Breast Cancer? A SEER Cohort Database Study.Journal of clinical medicine · 2025Article
- An Overview of the Importance of Neoadjuvant Systemic Therapy for Breast Cancer Patients: From the Society of Surgical Oncology and the American Society of Breast Surgeons.Annals of surgical oncology · 2025Review
- Impact of routine FDG-PET/CT on locoregional treatment decisions in breast cancer patients receiving preoperative systemic therapy.Breast (Edinburgh, Scotland) · 2025Article
- Real-World Assessment of Locoregional Management of the Axilla in Node-Positive Breast Cancer After Neoadjuvant Chemotherapy.Annals of surgical oncology · 2025Article
- Observational
- Review
- Article
- Management of the axilla in breast cancer patients: critical review, regional modified Delphi consensus and implementation in the Tuscan breast network.La Radiologia medica · 2024Review
- Outcomes of sentinel node biopsy according to MRI response in an association with the subtypes in cN1-3 breast cancer after neoadjuvant systemic therapy, multicenter cohort study.Breast cancer research : BCR · 2024Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAxillary lymph node dissection (ALND) can be avoided in node-positive patients who receive neoadjuvant chemotherapy (NAC) if three or more negative sentinel lymph nodes (SLNs) are retrieved. We evaluate how often node-positive patients avoid ALND with NAC, and identify predictors of identification of three or more SLNs and of nodal pathological complete response (pCR).
methodsFrom November 2013 to July 2019, all patients with cT1-3, biopsy-proven N1 tumors who converted to cN0 after NAC received SLN biopsy (SLNB) with dual mapping and were identified from a prospectively maintained database.
results630 consecutive N1 patients were eligible for axillary downstaging with NAC; 573 (91%) converted to cN0 and had SLNB, and 531 patients (93%) had three or more SLNs identified. Lymphovascular invasion (LVI; odds ratio [OR] 0.46, 95% confidence interval [CI] 0.24-0.87; p = 0.02) and increasing body mass index (BMI; OR 0.77, 95% CI 0.62-0.96 per 5-unit increase; p = 0.02) were significantly associated with failure to identify three or more SLNs. 255/573 (46%) patients achieved nodal pCR; 237 (41%) had adequate mapping. Factors associated with ALND avoidance included high grade (OR 2.51, 95% CI 1.6-3.94, p = 0.001) and receptor status (HR+/HER2- [referent]: OR 1.99, 95% CI 1.15-3.46 [p = 0.01] for HR-/HER2-, OR 3.93, 95% CI 2.40-6.44 [p < 0.001] for HR+/HER2+, and OR 8.24, 95% CI 4.16-16.3 [p < 0.001] for HR-/HER2+). LVI was associated with a lower likelihood of avoiding ALND (OR 0.28, 95% CI 0.18-0.43; p < 0.001).
conclusionsALND was avoided in 41% of cN1 patients after NAC. Increased BMI and LVI were associated with lower retrieval rates of three or more SLNs. ALND avoidance rates varied with receptor status, grade, and LVI. These factors help select patients most likely to avoid ALND.
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