Evidence map›Paper›PMID 39971858›Full record

ArticleAnnals of surgical oncology2025

Real-World Assessment of Locoregional Management of the Axilla in Node-Positive Breast Cancer After Neoadjuvant Chemotherapy.

Katherine Fleshner, Yuan Xu, Susan Isherwood, Flora Yang, Jade Pyo, Akaya Blair, Juliette Hall, Emily Hanniman, Antoine Bouchard-Fortier, May Lynn Quan

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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. Not yet cited in PubMed.

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1 · What the graph read from it

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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.

2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Katherine FleshnerDepartment of Surgery, University of Calgary, Calgary, AB, Canada. Katherine.fleshner@ucalgary.ca.
Yuan XuDepartment of Oncology, Arthur Child Comprehensive Cancer Centre, Calgary, AB, Canada.
Susan IsherwoodDepartment of Surgery, University of Calgary, Calgary, AB, Canada.
Flora YangDepartment of Oncology, Arthur Child Comprehensive Cancer Centre, Calgary, AB, Canada.
Jade PyoCumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Akaya BlairCumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Juliette HallCumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Emily HannimanDepartment of Family Medicine, University of Calgary, Calgary, AB, Canada.
Antoine Bouchard-FortierDepartment of Surgery, University of Calgary, Calgary, AB, Canada.
May Lynn QuanDepartment of Surgery, University of Calgary, Calgary, AB, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is limited level I evidence guiding axillary management in patients with node-positive breast cancer downstaged post-neoadjuvant chemotherapy (NAC) to clinically node-negative. We aimed to describe practice patterns among cN+ patients after NAC and examine predictors of subsequent completion axillary lymph node dissection (cALND) and recurrence among patients who initially underwent sentinel lymph node biopsy (SLNB). PATIENTS AND

methodsThis was a retrospective, population-based cohort of patients with cN+ breast cancer who underwent NAC then surgery in Alberta from January 2016 to September 2021. Practice patterns were described. Chart review was performed for patients receiving definitive SLNB at the index surgery; the outcomes were rates of subsequent cALND and recurrence.

resultsThe total cohort comprised 850 patients. Median age was 52 years, 584 patients (68.7%) had cT1/T2 disease before NAC, and 395 patients (46.5%) were HR+/HER2-. A total of 472 patients (55.5%) underwent SLNB but 108 were converted intraoperatively to ALND. On final pathology, 189/364 (51.9%) had a pathologic complete response, and most (95.1%) had adjuvant RT. Only 39 ypN+ patients (22.2%) had a cALND. After a median of 46.7 months, 52/364 (14.3%) patients recurred; 7/10 patients with regional recurrence did not undergo cALND, but 2 subsequently underwent salvage ALND. On multivariate analysis, very high/low body mass index (BMI), triple-negative disease, cT3/4 disease pre-NAC, and positive SLNB were predictors of recurrence.

conclusionsUptake of cALND for ypN+ patients in a real-world setting with frequent administration of RT was lower than expected. Regional recurrences were rare, suggesting that a nuanced approach to cALND may be feasible.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsLymph Node ExcisionNeoadjuvant TherapyNeoplasm Recurrence, LocalPractice Patterns, Physicians'AdultAgedAxillaChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansLymphatic MetastasisLymph NodesMiddle AgedAxillaAxillary lymph node dissectionBreast cancerNeoadjuvant chemotherapy

Identifiers

PMID39971858

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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.