Observational studyAnnals of surgical oncology2025
Oncologic Outcomes with De-Escalation of Axillary Surgery After Neoadjuvant Chemotherapy for Breast Cancer: Results from > 1500 Patients on the I-SPY2 Clinical Trial.
Observational study 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 18 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed.
- Nodal Pathologic Response After Neoadjuvant Systemic Therapy in Clinically Advanced Node-Positive (cN2 and cN3) Breast Cancer.Annals of surgical oncology · 2026Article
- Optimizing axillary surgery for patients with clinically node-negative and node-positive breast cancer.Surgery today · 2026Review
- Factors Associated with Omission of Axillary Lymph Node Dissection for Patients with Clinical Node-Positive Breast Cancer Who have Residual Nodal Disease on Pathology After Neoadjuvant Chemotherapy.Annals of surgical oncology · 2026Observational
- ASO Author Reflections: What Extent of Axillary Surgery Counts? Rethinking Total and Positive Lymph Node Counts After Neoadjuvant Chemotherapy in Young Women with Node-Positive Breast Cancer.Annals of surgical oncology · 2026Article
- Impact of Total and Positive Lymph Node Count on Recurrence in Young Women with Node-Positive Breast Cancer Undergoing Neoadjuvant Chemotherapy.Annals of surgical oncology · 2026Article
- ASO Author Reflections: Rethinking Axillary Management in cN2-cN3 Breast Cancer.Annals of surgical oncology · 2026Article
- Evolution of Axillary Surgical Management of Patients with Occult Breast Cancer with Axillary Metastasis.Annals of surgical oncology · 2026Article
- Axillary surgery after neoadjuvant therapy: rethinking completion axillary dissection for residual micrometastatic disease.Translational cancer research · 2026Article
- The 19th St. Gallen international breast cancer conference 'primary therapy of patients with early breast cancer. Evidence, controversies, consensus': key moments and breakthroughs.Ecancermedicalscience · 2026Article
- Molecular and Biological Features of Invasive Lobular Carcinoma: Toward New Treatment Strategies.Annals of surgical oncology · 2026Review
- De-escalating the axilla: oncologic and morbidity outcomes of targeted axillary dissection versus axillary lymph node dissection following neoadjuvant systemic therapy in clinically node-positive breast cancer within a single institution.Frontiers in oncology · 2026Article
- Axillary surgical de-escalation after neoadjuvant therapy in breast cancer: current evidence, clinical controversies, and future directions.Frontiers in oncology · 2026Review
- The Canadian Breast Cancer Symposium 2025: Meeting Report.Current oncology (Toronto, Ont.) · 2025Article
- ASO Author Reflections: Is Axillary Lymph Node Dissection Always Justified for Residual Axillary Disease in Breast Cancer After Neoadjuvant Chemotherapy?Annals of surgical oncology · 2025Article
- Clinical Trials and Their Implementation: Lessons Learned.Annals of surgical oncology · 2025Article
- Is the Clipped Node Enough? Successful Retrieval and False Negative Rate of the Clipped Node After Neoadjuvant Chemotherapy.Annals of surgical oncology · 2025Article
- BJS commission on the surgical management of the axilla in breast cancer.The British journal of surgery · 2025Article
- Axillary management in patients with sentinel lymph node micrometastases following neoadjuvant systemic therapy: a call for de-escalation.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Article
Corrections and comments
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Authors and funding
22 authors.
Funding
Abstract
introductionThe desire to reduce patient morbidity has led to de-escalation of axillary surgery after neoadjuvant chemotherapy (NAC) for breast cancer; however, the impact of such de-escalation on oncologic outcomes is unknown.
methodsWe evaluated the relationship between axillary surgery type (sentinel lymph node [SLN] only vs. axillary lymph node dissection [ALND]) and 5-year outcomes in I-SPY2 trial patients from 2011 to 2022 who completed NAC and surgery. Rates of axillary recurrence (AxR), locoregional recurrence (LRR), distant recurrence-free survival (DRFS), and event-free survival (EFS) were compared.
resultsOf 1515 patients, SLN-only was performed in 804/1014 (79.3%) ypN0 patients and 127/501 (25.3%) ypN+ patients. Median follow-up time was 3.5 years. Most patients received adjuvant radiation (73.8% of ypN0 patients and 90.8% of ypN+ patients). In ypN0 cases, there was no difference between the SLN-only and ALND groups in 5-year estimated AxR (2.0% vs. 0.8%, p = 0.57), LRR (4.6% vs. 4.4%, p = 0.72), or EFS (88.3% vs. 86.4%, p = 0.09). On multivariable analysis, SLN-only was associated with better DRFS (90.8% vs. 87.9%; hazard ratio [HR] 0.54, p = 0.04). In ypN+ cases, there was no difference between the SLN-only and ALND groups in 5-year estimated AxR (5.2% vs. 3.6%, p = 0.81), LRR (7.7% vs. 14%, p = 0.13), DRFS (70.0% vs. 66.7%, p = 0.09), or EFS (70.4% vs. 63.2%, p = 0.07).
conclusionsWith short-term follow-up, omission of ALND in selected patients was not associated with worse AxR, LRR, DRFS, or EFS in patients with ypN0 or ypN+ disease. While prospective trial results are awaited, these data suggest that ALND may not be necessary for all patients with residual nodal disease after NAC.
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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.