Evidence map›Paper›PMID 42135887›Full record

ArticleAnnals of surgery2026

Clipped Node Pathology as a Guide for Limited Axillary Surgery in Occult Breast Cancer.

Courtney M Lattimore, Helen M Johnson, Henry M Kuerer, Abigail S Caudle, Sharon H Giordano, Puneet Singh, Kelly K Hunt, Lei Huo, Kerollos Nashat Wanis

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

What it found

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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

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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.

Courtney M LattimoreDepartment of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Helen M JohnsonDepartment of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Henry M KuererDepartment of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abigail S CaudleDepartment of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Sharon H GiordanoDepartment of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Puneet SinghDepartment of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Kelly K HuntDepartment of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Lei HuoDepartment of Anatomical Pathology, Division of Pathology-Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Kerollos Nashat WanisDepartment of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

objectiveTo evaluate pathologic complete response (pCR) in patients with occult breast cancer (OBC) treated with neoadjuvant systemic therapy (NST), and to investigate whether pathologic changes in the pre-treatment biopsy-proven clipped axillary lymph node (ALN) reflect the residual axillary disease burden following NST. SUMMARY BACKGROUND DATA: Current international guidelines recommend ALN dissection for all patients with OBC. These patients have limited representation in studies of axillary surgery de-escalation.

methodsUsing data from an observational cohort study of patients diagnosed with OBC between 2010 and 2025, we estimated the probability of pCR, and the diagnostic test characteristics of the pre-treatment biopsy-positive clipped node pathology for evaluating residual axillary disease burden after NST.

resultsAmong 85 patients with OBC who received NST followed by surgery, pCR occurred in 12 (33.3%) of 36 with hormone receptor (HR)-positive/HER2-negative, 15 (83.3%) of 18 with HER2-positive, and 24 (77.4%) of 31 with HR-negative/HER2-negative disease. There were 46 (54.1%) patients who had a clip placed in the biopsy-proven positive node at diagnosis. Pathologic assessment of the clipped node had a specificity of 88.6% (95% CI: 75.1, 96.0%) and a false-negative rate (FNR) of 13.3% (95% CI: 2.9, 36.3%) in all OBC patients. In patients with cN1 or cN2 disease, the specificity was 86.2% (95% CI: 70.5, 95.2%) and FNR was 0% (95% CI: 0, 21.7%).

conclusionsIn patients with OBC, pathologic assessment of the clipped node can reflect disease burden in the remaining ALNs. Limited axillary surgery anchored in removal of the clipped node should be considered as a strategy for axillary staging following systemic therapy in selected patients with OBC, primarily those with cN1 or cN2 disease.

Indexed as

axillary stagingclipped node pathologyneoadjuvant systemic therapyOccult breast cancertargeted axillary dissection

Identifiers

PMID42135887
PMCPMC13200909

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