ArticleBreast cancer research and treatment2025
Trends in management and related outcomes for occult primary breast cancer.
Article in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- 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
- Evolution of Axillary Surgical Management of Patients with Occult Breast Cancer with Axillary Metastasis.Annals of surgical oncology · 2026Article
- Is Mastectomy Necessary in Patients with Occult Breast Cancer and Advanced (N2/N3) Nodal Disease?Annals of surgical oncology · 2026Observational
- Overall survival outcomes in occult primary breast cancer.Breast (Edinburgh, Scotland) · 2026Article
- Omission of Axillary Lymph Node Dissection in Patients with pT0-2 ER+/HER2- Breast Cancer with 3-5 Positive Lymph Nodes Undergoing Adjuvant Systemic Therapy and Radiation Does Not Impact Overall Survival: A National Cancer Database Analysis.Annals of surgical oncology · 2026Article
- Case Report: Interpectoral lymph node metastasis as an indicator of occult breast cancer: a case of double primary malignancy.Frontiers in oncology · 2026Article
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Authors and funding
7 authors.
Funding
Abstract
purposeOccult Primary Breast Cancer (OPBC) is a rare clinical condition in which breast cancer is located within the axillary lymph nodes, but no primary tumor is identified in the breast. We evaluated trends of neoadjuvant chemotherapy (NAC) use and subsequent axillary procedures in OPBC as well as outcomes for these patients.
methodsThe National Cancer Database was used to identify adult women with cT0N1-3M0 breast cancer between 2012 to 2021 that underwent axillary lymph node surgery. Kaplan-Meier curves were used to evaluate survival between groups.
results2759 patients met inclusion criteria. 86.2% underwent ALND alone in 2012, and this decreased to 65.6% in 2021. 4.7% underwent SLNB alone in 2012 and this increased to 16.2% in 2021 (p < 0.001). For patients who had undergone NAC, 46.4% of ALND patients had nodal pathologic complete response (nPCR), compared to 42.7% of SLNB + ALND and 66.4% of SLNB only patients. For patients with nPCR, there was no difference in overall survival (OS) between ALND, SLNB + ALND, and SLNB alone groups (p = 0.9912).
conclusionMost OPBC patients were treated with ALND, with a modest increase towards SLNB use during the study period. There was no difference in OS with respect to axillary surgical procedure in our population for those with nPCR after NAC. This suggests that for carefully selected OPBC patients with an excellent clinical response to NAC and negative SLNB, omission of ALND may be considered.
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