ArticleScientific reports2025
Feasibility of de-escalating axillary surgery in patients with clinical N2-3, pathological N0 breast cancer after neoadjuvant chemotherapy.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07643584 (DEMAND - A Phase II Trial of De-Escalation of Axillary Management in Advanced Nodal Disease), which is not on this map. Cited by 3 papers.
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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.
DEMAND - A Phase II Trial of De-Escalation of Axillary Management in Advanced Nodal Disease
Who cites it
3 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
- Nodal Pathologic Response After Neoadjuvant Systemic Therapy in Clinically Advanced Node-Positive (cN2 and cN3) Breast Cancer.Annals of surgical oncology · 2026Article
- De-escalation of axillary surgery after neoadjuvant therapy in breast cancer: long-term outcomes of sentinel lymph node biopsy alone versus complete axillary lymph node dissection.Therapeutic advances in medical oncology · 2026Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Axillary lymph node dissection (ALND) omission improves quality of life but is only considered under certain conditions. We investigated expanding these conditions in patients receiving neoadjuvant chemotherapy (NAC) for clinical N2-3, pathological N0 breast cancer. We retrospectively reviewed data of 1346 patients with clinical N2-3, M0, who underwent surgical resection (sentinel lymph node biopsy [SLNB] only, or level I-II ALND with/without SLNB) following NAC from January 2008 to December 2021. Univariate and multivariate analyses of overall (OS), disease-free (DFS), regional recurrence-free (RFS), and axillary recurrence-free survival (ARFS) were performed before and after propensity score matching (PSM) to control for confounding factors. Of the total patients, 521 (37.5%) achieved an axillary pathological complete response (ypN0). Of these, 293 (56.2%) underwent SLNB only. The median OS was 52.7 months. After PSM, SLNB-only and ALND groups showed no significant differences in ARFS (long-rank p = 0.765), RFS (long-rank p = 0.764), DFS (long-rank p = 0.186), and OS (long-rank p = 0.760). The 5-year ARFS (97.3 vs. 96.7%) and OS (97.7 vs. 97.3%) of both groups did not differ significantly. ALND omission after NAC in clinical N2-3, pathological N0 patients was not inferior to ALND,. Clinical N2-3 patients achieving ypN0 following NAC may be safely treated with SLNB alone.
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