ArticleAnnals of surgical oncology2025
Outcomes and Trends in Axillary Management of Stage cN3b Breast Cancer Patients.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 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
- Advanced Nodal Disease is Not a Single Stratum: Refining Eligibility for Targeted Axillary Dissection After Neoadjuvant Therapy.Annals of surgical oncology · 2026Article
- Review
- Case Report: Personalized management of HER2-positive breast cancer with advanced nodal disease during pregnancy: a clinical case and review.Frontiers in oncology · 2025Article
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7 authors.
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Abstract
backgroundThere is limited data regarding sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for cN3b patients, who present with both axillary and ipsilateral internal mammary node involvement. We examined trends in the use of SLNB in cN3b patients and survival by axillary procedure for those with nodal pathologic complete response (nPCR).
methodsAdult women with nonmetastatic cN3b invasive breast carcinoma between 2012 and 2021 were selected from the National Cancer Database. These patients were compared based on type of axillary surgery, specifically SLNB, SLNB with axillary lymph node dissection (ALND), and ALND alone. Kaplan-Meier analysis was used to compare overall survival.
resultsA total of 4,236 patients were included. In 2012, 8.5% of these patients underwent SLNB alone and 18.3% underwent SLNB+ALND. In 2021, this increased to 35.1% for SLNB alone and 23.0% for SLNB with subsequent ALND (p < 0.0001). For patients who received NAC, the rate of nPCR was overall found to be 24.9%. Overall survival of patients receiving SLNB or SLNB+ALND with nPCR was not statistically significantly different from the ALND only group with nPCR (p = 0.22 and 0.57, respectively).
conclusionsThere has been increasing use of the SLNB procedure for patients with cN3b breast cancer over the past decade. In patients with nPCR, SLNB was not associated with reduced survival. For well-selected cN3b patients with an excellent clinical response to NAC, including nPCR, axillary de-escalation strategies, such as SLNB with omission of completion axillary dissection, may be considered.
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