ArticleBJS open2025
De-escalation of axillary surgery and targeted axillary dissection following neoadjuvant chemotherapy: multicentre prospective regional audit.
Article in BJS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Influencing factors on seroma formation following mastectomy: a retrospective cohort study.World journal of surgical oncology · 2026Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundEmerging evidence supports axillary de-escalation in patients with clinically node-positive breast cancer with low-volume residual disease following neoadjuvant chemotherapy, avoiding axillary node clearance in selected patients. Targeted axillary dissection, which retrieves a known metastatic, clipped node alongside standard sentinel node biopsy aims to reduce false-negative rates. This study evaluated axillary surgery after neoadjuvant chemotherapy across NHS Greater Glasgow and Clyde, and examined 10-year trends.
methodsPatients with node-positive breast cancer receiving neoadjuvant chemotherapy between 2017 and 2024 were identified from multidisciplinary team records. Clinicopathological and surgical data were collected. Outcomes were compared using χ2 tests and logistic regression. Additional data from 2015-2016 were extracted from the Regional Cancer Registry.
resultsOf 498 patients, primary axillary surgery included Magseed®-localized targeted axillary dissection (27.5%), wire-localized targeted axillary dissection (0.4%), non-localized targeted axillary dissection (7.0%), sentinel node biopsy (14.3%), and axillary node clearance (50.8%). The clipped node retrieval rate was 100% with Magseed®-localized and 91.4% with non-localized targeted axillary dissection; sentinel node concordance rates were 85.8 and 66.7%, respectively. Completion axillary node clearance was undertaken in 27 patients (11.0%) and was associated with an increased risk of complications including seroma, restricted shoulder movement, and wound infection, compared with de-escalated surgery (odds ratio (OR) 2.88, 95% confidence interval (CI) 1.28 to 6.49; P = 0.011) and upfront axillary node clearance (OR 1.86, 95% CI 1.27 to 2.72; P = 0.001). Use of axillary de-escalation increased over 10 years, surpassing 50% recently (χ²(4) = 25.3, P < 0.001).
conclusionTargeted axillary dissection enables safe de-escalation of axillary surgery in patients with low-volume residual disease. Localization enhances clipped node retrieval. Completion axillary node clearance carries higher morbidity, reinforcing the need for careful patient selection.
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