ArticleAnnals of surgical oncology2022
Is Nodal Clipping Beneficial for Node-Positive Breast Cancer Patients Receiving Neoadjuvant Chemotherapy?
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis 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
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 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
- Is the Clipped Node Enough? Successful Retrieval and False Negative Rate of the Clipped Node After Neoadjuvant Chemotherapy.Annals of surgical oncology · 2025Article
- The Evolution of Axillary Surgery in Breast Cancer-Towards De-escalation.Balkan medical journal · 2025Article
- De-Escalation of Nodal Surgery in Clinically Node-Positive Breast Cancer.JAMA surgery · 2025Observational
- Impact of Clipped Node as a Sentinel Lymph Node on Axillary Staging Following Neoadjuvant Chemotherapy in Clinically Node-Positive Breast Cancer.Annals of surgical oncology · 2025Article
- Clipping the Positive Lymph Node in Patients with Clinically Node Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: Impact on Axillary Surgery in the ISPY-2 Clinical Trial.Annals of surgical oncology · 2024Article
- Clipped Axillary Node as a Potential Surrogate for Overall Axillary Nodal Status in Inflammatory Breast Cancer Patients after Neoadjuvant Chemotherapy.Annals of surgical oncology · 2024Article
- Two step procedures: sequels are never any good.Gland surgery · 2024Article
- Targeted axillary dissection reduces residual nodal disease in clinically node- positive breast cancer after neoadjuvant chemotherapy.World journal of surgical oncology · 2024Article
- Clipping a Positive Lymph Node Improves Accuracy of Nodal Staging After Neoadjuvant Chemotherapy for Breast Cancer Patients, but Does It Drive Management Changes?Annals of surgical oncology · 2024Article
- Radiographic identification of a positive clipped axillary lymph node in a mastectomy specimen following neoadjuvant chemotherapy.Radiology case reports · 2024Article
- Staging of the Axilla After Neoadjuvant Chemotherapy: Which Technique is Better? The Endless Debate.Annals of surgical oncology · 2023Article
- The role of irradiation in the management of the axilla in early breast cancer patients.Frontiers in oncology · 2023Review
- 23rd Annual Meeting of the American Society of Breast Surgeons: Back to In-Person Scientific Exploration.Annals of surgical oncology · 2022Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIn cN1 patients rendered cN0 with neoadjuvant chemotherapy, the false-negative rate of sentinel lymph node biopsy (SLNB) is < 10% when ≥ 3 sentinel lymph nodes (SLNs) are removed. The added value of nodal clipping in this scenario is unknown. Here we determine how often the clipped node is a sentinel node when ≥ 3 SLNs are retrieved.
methodsWe identified cT1-3N1 patients treated between 02/2018 and 10/2021 with a clipped lymph node at presentation. SLNB was performed with a standardized approach of dual-tracer mapping and retrieval of ≥ 3 SLNs. Clipped nodes were not localized; SLNs were X-rayed intraoperatively to determine clip location. Axillary lymph node dissection (ALND) was performed for any residual disease or retrieval of < 3 SLNs.
resultsOf 269 patients, 251 (93%) had ≥ 3 SLNs. Median age was 51 years; the majority (92%) had ductal histology; 46% were HR+/HER2-. The median number of SLNs removed was 4 (IQR 3,5). The clipped node was an SLN in 88% (220/251) of cases. Of the 31 where the clipped node was not, 13 had a positive SLN mandating ALND, and the clip was identified in the ALND specimen. In the remaining 18, where ≥ 3 negative SLNs were retrieved and an ALND was not performed, the clip was not retrieved, with no axillary failures in this group (median follow-up: 55 months).
conclusionWhen the SLNB procedure is optimized with dual tracer and retrieval of ≥ 3 SLNs, the clipped node is an SLN in the majority of cases, suggesting that failure to retrieve the clipped node should not be an indication for ALND.
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