Observational studyCancer2025
Combined analysis of the MF18-02/MF18-03 NEOSENTITURK studies: ypN-positive disease does not necessitate axillary lymph node dissection in patients with breast cancer with a good response to neoadjuvant chemotherapy as long as radiotherapy is provided.
Observational study in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Is sentinel lymph node biopsy with radiotherapy alone without axillary lymph node dissection safe following neoadjuvant chemotherapy in initially clinically axilla positive patients: neosentiturk-trial/mf-18-03
DEMAND - A Phase II Trial of De-Escalation of Axillary Management in Advanced Nodal Disease
Who cites it
12 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
- Evolution of Axillary Surgical Management of Patients with Occult Breast Cancer with Axillary Metastasis.Annals of surgical oncology · 2026Article
- The Past, Present, and Future of Sentinel Lymph Node Biopsy in Breast Cancer.Annals of surgical oncology · 2026Review
- Targeted axillary dissection in breast cancer patients: a systematic review and meta-analysis.NPJ breast cancer · 2026Article
- Clipped Node Pathology as a Guide for Limited Axillary Surgery in Occult Breast Cancer.Annals of surgery · 2026Article
- Omission of frozen section in sentinel lymph node biopsy after neoadjuvant chemotherapy in cN0 HER2-positive and TNBC.Frontiers in oncology · 2026Article
- Review
- Factors Predicting Additional Residual Nodal Disease With a Metastatic Sentinel Node Biopsy or Targeted Axillary Dissection After Neoadjuvant Chemotherapy.Journal of breast cancer · 2025Article
- Changing practice patterns in axillary management for patients with node-positive breast cancer towards increased use of sentinel lymph node biopsy-alone after neoadjuvant chemotherapy: results of a survey (MF17-01) among Turkish surgeons.Langenbeck's archives of surgery · 2025Article
- Article
- Observational
- De-escalation of axillary interventions in the management of breast cancer patients following neoadjuvant systemic treatment.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
56 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe omission of axillary lymph node dissection (ALND) remains controversial for patients with residual axillary disease after neoadjuvant chemotherapy (NAC), regardless of the residual burden. This study evaluated the oncologic safety and factors associated with outcomes in patients with residual axillary disease. These patients were treated solely with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD), without ALND, after NAC.
methodsA joint analysis of two different multicenter cohorts-the retrospective cohort registry MF18-02 and the prospective observational cohort registry MF18-03 (NCT04250129)-was conducted between January 2004 and August 2022. All patients received regional nodal irradiation.
resultsFive hundred and one patients with cT1-4, N1-3M0 disease who achieved a complete clinical response to NAC underwent either SLNB alone (n = 353) or TAD alone (n = 148). At a median follow-up of 42 months, axillary and locoregional recurrence rates were 0.4% (n = 2) and 0.8% (n = 4). No significant difference was found in disease-free survival (DFS) and disease-specific survival (DSS) rates between patients undergoing TAD alone versus SLNB alone, those with breast positive versus negative pathologic complete response, SLN methodology, total metastatic LN of one versus ≥2, or metastasis types as isolated tumor cells with micrometastases versus macrometastases. In the multivariate analysis, patients with nonluminal pathology were more likely to have a worse DFS and DSS, respectively, without an increased axillary recurrence.
conclusionsThe omission of ALND can be safely considered for patients who achieve a complete clinical response after NAC, even if residual disease is detected by pathologic examination. Provided that adjuvant radiotherapy is administered, neither the SLNB method nor the number of excised LNs significantly affects oncologic outcomes.
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Registered trials
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.