Evidence map›Paper›PMID 40463878›Full record

ArticleFrontiers in oncology2025

Evaluating the survival outcomes in clinical node stage 2 and 3 breast cancer patients with negative sentinel lymph node biopsy after neoadjuvant chemotherapy: sentinel lymph node biopsy alone vs. axillary lymph node dissection.

Eunju Shin, Tae-Kyung Yoo, Jisun Kim, Il Yong Chung, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Sae Byul Lee

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in oncology, 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 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

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.

NCT07643584 phase2not yet recruitingnot on this mapstarted 2026, after this paper: background citation

DEMAND - A Phase II Trial of De-Escalation of Axillary Management in Advanced Nodal Disease

TypeinterventionalSponsorUniversity of Kansas Medical CenterRan2026 to 2031Enrolled120ConditionsBreast CancerArmsAxillary Surgery
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
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  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Eunju ShinDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Tae-Kyung YooDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Jisun KimDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Il Yong ChungDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Beom Seok KoDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Hee Jeong KimDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Jong Won LeeDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Byung Ho SonDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Sae Byul LeeDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: With the advancement of neoadjuvant chemotherapy (NAC), the reliance on surgical removal of axillary for high-risk breast cancer is diminishing. However, there is a lack of data on the oncologic safety of sentinel lymph node biopsy (SNB) alone in patients with clinical node stages 2 and 3 who show a favorable response to NAC. This study aims to compare the oncologic outcomes of SNB alone versus SNB combined with axillary lymph node dissection (ALND) in this patient cohort. Methods: Conducted at Asan Medical Center, this retrospective study analyzed data from breast cancer patients treated with NAC between 2008 and 2021. Propensity score matching (PSM) was employed to compare patients based on treatment approach. SNB was performed on patients demonstrating significant response to NAC with minimal nodal involvement and ALND was reserved for cases with negative SNB results, as determined by the operating surgeon. The study evaluated oncologic safety by comparing axillary recurrence-free survival (ARFS), regional recurrence-free survival (RRFS), and overall survival (OS) across surgical methods. Results: Over a median follow-up of 44 months, the overall axillary recurrence rate was 2.3%, and the univariate and multivariate analyses showed no statistically significant differences in ARFS, RRFS, and OS between the groups. Propensity score-matched analysis further confirmed the absence of significant differences in 5-year ARFS, RRFS, and OS outcomes between the SNB-only and ALND groups. Conclusions: This study demonstrates that performing sentinel node biopsy alone is feasible in patients with clinical node stage 2-3 after neoadjuvant chemotherapy. The findings suggest the potential for de-escalation of axillary management in these patients, which could be further explored in follow-up studies.

Indexed as

axillary lymph node dissectionaxillary surgerybreast cancerneoadjuvant chemotherapysentinel lymph node biopsy

Identifiers

PMID40463878
PMCPMC12129956

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