ArticleCancer medicine2026
Post-Neoadjuvant Chemotherapy Axillary Ultrasound in cN+ Breast Cancer: Can It Reliably Support de-Escalation of Axillary Surgery?
Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
backgroundNeoadjuvant chemotherapy (NAC) in up to 40%-60% of node-positive (cN+) breast cancer patients allows nodal pathological complete response, particularly in Her2+ and triple-negative subtypes. Accurate post-NAC axillary restaging is therefore critical to identify candidates for surgical de-escalation. Axillary ultrasound (AUS) remains the most widely used tool, but prior studies report highly variable performance, with false-negative rates approaching 25%, raising concerns about its reliability as a standalone guide.
methodsWe retrospectively evaluated 413 patients with biopsy-proven cN+ breast cancer treated with NAC (2000-2024). All underwent AUS before surgery. AUS results (ycN0 vs. ycN+) were compared with final pathology (ypN0 vs. ypN+). Diagnostic performance was assessed, and predictors of false-negative AUS were identified using logistic regression.
resultsAUS classified 51.6% of patients as ycN0, whereas only 45% achieved nodal pathologic complete response. Overall, AUS demonstrated 68% sensitivity, 76% specificity, 72% accuracy, positive predictive value 78%, and negative predictive value 66%. Performance differed by subtype: accuracy was highest in ER-/Her2 tumors (75%), but markedly lower in Her2+ (69%) and lobular carcinoma (67%). On multivariate analysis, absence of breast clinical complete response (OR 2.38, 95% CI [1.14-4.93]) independently predicted false-negative AUS findings.
conclusionsAUS following NAC provides only moderate accuracy, with a clinically relevant risk in patients lacking breast response. AUS alone should not determine omission of axillary surgery. A multimodal, biology-informed strategy combining AUS with other imaging techniques is needed to safely guide axillary de-escalation and minimize both overtreatment and undertreatment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.