ArticleWorld journal of surgical oncology2024
Targeted axillary dissection reduces residual nodal disease in clinically node- positive breast cancer after neoadjuvant chemotherapy.
Article in World journal 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, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Impact of axillary disease extent defined by baselineBreast (Edinburgh, Scotland) · 2026Article
- Axillary Recurrence After a Negative Sentinel Lymph Node Biopsy (SLNB) for Initial Positive Node Breast Cancer Postneoadjuvant Therapy: Insights From a Systematic Review and Meta-Analysis.The breast journal · 2026Review
- Axillary response and diagnostic accuracy of imaging modalities after neoadjuvant chemotherapy for breast cancer (retrospective single center study).Frontiers in surgery · 2026Article
- Factors Predicting Additional Residual Nodal Disease With a Metastatic Sentinel Node Biopsy or Targeted Axillary Dissection After Neoadjuvant Chemotherapy.Journal of breast cancer · 2025Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAny advantage of performing targeted axillary dissection (TAD) compared to sentinel lymph node (SLN) biopsy (SLNB) is under debate in clinically node-positive (cN+) patients diagnosed with breast cancer. Our objective was to assess the feasibility of the removal of the clipped node (RCN) with TAD or without imaging-guided localisation by SLNB to reduce the residual axillary disease in completion axillary lymph node dissection (cALND) in cN+ breast cancer.
methodsA combined analysis of two prospective cohorts, including 253 patients who underwent SLNB with/without TAD and with/without ALND following NAC, was performed. Finally, 222 patients (cT1-3N1/ycN0M0) with a clipped lymph node that was radiologically visible were analyzed.
resultsOverall, the clipped node was successfully identified in 246 patients (97.2%) by imaging. Of 222 patients, the clipped lymph nodes were non-SLNs in 44 patients (19.8%). Of patients in cohort B (n=129) with TAD, the clipped node was successfully removed by preoperative image-guided localisation, or the clipped lymph node was removed as the SLN as detected on preoperative SPECT-CT. Among patients with ypSLN(+) (n=109), no significant difference was found in non-SLN positivity at cALND between patients with TAD and RCN (41.7% vs. 46.9%, p=0.581). In the subgroup with TAD with axillary lymph node dissection (ALND; n=60), however, patients with a lymph node (LN) ratio (LNR) less than 50% and one metastatic LN in the TAD specimen were found to have significantly decreased non-SLN positivity compared to others (27.6% vs. 54.8%, p=0.032, and 22.2% vs. 50%, p=0.046).
conclusionsTAD by imaging-guided localisation is feasible with excellent identification rates of the clipped node. This approach has also been found to reduce the additional non-SLN positivity rate to encourage omitting ALND in patients with a low metastatic burden undergoing TAD.
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