ArticleBreast (Edinburgh, Scotland)2022
De-escalating axillary surgery in early-stage breast cancer.
Article in Breast (Edinburgh, Scotland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Safety analysis of omitting axillary lymph node dissection in early-stage breast cancer with 1-2 sentinel lymph nodes macro-metastases: a meta-analysis.Frontiers in oncology · 2025Pooled it
- Uncertainties and controversies in axillary management of patients with breast cancer.Cancer treatment reviews · 2023Pooled it
- Predicting sentinel lymph node metastasis in breast cancer using an interpretable machine learning approach based on multi-domain clinical features.Breast cancer research : BCR · 2026Article
- Langer's Axillary Arch: A Systematic Review and Meta-Analysis of Its Prevalence and Clinical Relevance.Life (Basel, Switzerland) · 2026Review
- Economic and Health System Impact of Implementing the SOUND Trial Approach in Early-Stage Breast Cancer.Annals of surgical oncology · 2026Article
- Article
- Iodine seed-marking protocol for response-guided axillary de-escalation after neoadjuvant therapy in node-positive breast cancer.Translational cancer research · 2026Article
- Research on Omitting Sentinel Lymph Node Biopsy after Neoadjuvant Therapy in cN1 Breast Cancer Patients.Cancer medicine · 2026Article
- Selected Pathological Criteria That Predict Low Rates of Axillary Lymph Node Metastases Regardless of Patient Age: A Single Institution Study.The breast journal · 2026Article
- Omission of sentinel lymph node biopsy in breast cancer: a survey of Brazilian breast surgeons.Einstein (Sao Paulo, Brazil) · 2026Observational
- Preoperative localization of metastatic axillary lymph nodes using radioactive iodine seed before neoadjuvant chemotherapy. A one-step marking method for targeted axillary dissection.European journal of nuclear medicine and molecular imaging · 2026Article
- Risk stratification system for sentinel lymph node metastasis in clinically node-negative early breast cancer with sonographically abnormal but cytologically negative axilla.Scientific reports · 2025Article
- Ghost in the Axilla: Luminal-Type Breast Cancer and Occult Sentinel Node Metastasis After Neoadjuvant Chemotherapy.Journal of clinical medicine · 2025Article
- Prognostic Role of Preoperative Axillary Ultrasound for Lymph Node Metastasis and Recurrence in Early Stage Breast Cancers.Journal of breast cancer · 2025Article
- Nomogram for predicting axillary pathologic complete response in cN2-3 breast cancer after neoadjuvant chemotherapy.NPJ breast cancer · 2025Article
- Trends in Surgical Treatment for cT4 Breast Cancer After Neoadjuvant Systemic Therapy: A Nationwide Study in The Netherlands.Annals of surgical oncology · 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
- The Underlying Mechanisms and Emerging Strategies to Overcome Resistance in Breast Cancer.Cancers · 2025Review
- Is There a Therapeutic Benefit of Axillary Surgery in Non-Metastatic Breast Cancer? A SEER Cohort Database Study.Journal of clinical medicine · 2025Article
- BJS commission on the surgical management of the axilla in breast cancer.The British journal of surgery · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
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Abstract
The role of axillary surgery has evolved over the last three decades from routine axillary lymph node dissection (ALND) to sentinel lymph node biopsy to omission of axillary surgery altogether in select patients. This evolution has been achieved through the design and conduct of multiple clinical trials demonstrating that ALND does not impact survival and is not necessary for local control in patients with early-stage breast cancer and limited nodal involvement. Importantly, this practice-changing shift mirrored the trend towards earlier stage at diagnosis and the recognition of the interplay between local and systemic therapies in maintaining local control. There are numerous clinical scenarios today in which axillary staging can be safely avoided, including (1) DCIS treated with lumpectomy, (2) at the time of contralateral prophylactic mastectomy, and (3) in elderly patients with early-stage, HR+/HER2-clinically node-negative (cN0) disease. Ongoing clinical trials seek to expand the cohorts in which surgical nodal staging can be omitted. These populations include a broader range of early-stage, cN0 patients undergoing upfront surgery, as seen in the SOUND, INSEMA, BOOG 2013-08, SOAPET and NAUTILUS trials. Omission of axillary surgery in cN0 patients with HER2+ or triple-negative disease treated with neoadjuvant chemotherapy is also being tested in the ASICS and EUBREAST-01 trials. Continued advances in imaging and the growing role of genomic assays in selecting patients for systemic therapy are likely to further minimize the need for axillary surgery; thereby further reducing the morbidity of local therapy for women with breast cancer.
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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.