ArticleAnnals of surgical oncology2024
Residual Axillary Metastases in Node-Positive Breast Cancer Patients After Neoadjuvant Treatment: A Register-Based Study.
Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Retrospective study of comparable survival after neoadjuvant versus adjuvant chemotherapy in cT1-2N0M0 triple-negative breast cancer.Breast cancer research and treatment · 2026Article
- It Is Not an Obituary of Sentinel Lymph Node Biopsy or Surgery to Axilla, It's a De-Escalation of Surgery to Axilla in Early Breast Cancer: A Traditional Review.European journal of breast health · 2025Article
- Oncologic First Events in Breast Cancer Patients After Targeted Axillary Dissection.Annals of surgical oncology · 2025Article
- Additional Axillary Disease After Neoadjuvant Chemotherapy for Patients with Clinically Node-Negative but Sentinel Node-Positive Disease.Annals of surgical oncology · 2025Article
- Predicting the Probability of Residual Axillary Nodal Metastases in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2025Article
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Authors and funding
7 authors.
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Abstract
backgroundLymph node (LN) metastasis after neoadjuvant chemotherapy (NACT) generally warrants axillary lymph node dissection, which opposes guidelines of upfront surgery in many cases. We investigated the risk of having additional metastases in the axilla when the LNs removed by targeted axillary dissection (TAD) harbored metastases after NACT. We aimed to identify subgroups suitable for de-escalated axillary treatment.
methodsThis register-based study used data from the Danish Breast Cancer Cooperative Group database. Data were analyzed with logistic regression models. The primary outcome was the metastatic burden in non-TAD LNs in patients with positive TAD LNs after NACT.
resultsAmong 383 patients, < 66.6% positive TAD LNs (adjusted odds ratio [OR] 0.34, 95% confidence interval [CI] 0.17-0.62), only isolated tumor cells (ITCs) [OR 0.11, 95% CI < 0.01-0.82], and breast pathological complete response (pCR) [OR 0.07, 95% CI < 0.01-0.56] were associated with a low risk of having more than three positive non-TAD LNs. In 315 patients with fewer than three positive non-TAD LNs, the proportion of positive TAD LNs (OR 0.45, 95% CI 0.27-0.76 for 33.3-66.6% vs. > 66.6%), size of the TAD LN metastasis (OR 0.14, 95% CI 0.04-0.54 for ITC vs. macrometastasis), tumor size at diagnosis (OR 0.30, 95% CI 0.15-0.64 for 20-49 mm vs. ≥ 50 mm) and breast pCR (OR 0.38, 95% CI 0.15-0.96) were associated with residual LN metastases in the axilla.
conclusionsBreast pCR or ITC only in TAD LNs can, with reasonable certainty, preclude more than three positive non-TAD LNs. Additionally, patients with only ITCs in the TAD LN had a low risk of having any non-TAD LN metastases after NACT. De-escalated axillary treatment may be considered in both subgroups.
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