Evidence map›Paper›PMID 42365133›Full record

ArticleJournal of cancer research and clinical oncology2026

Stained region lymph node biopsy for axillary restaging after neoadjuvant systemic therapy in node-positive breast cancer: a cohort study.

Rui Chen, Hailing Zha, Qiannan Zhu, Xinpei Liu, Lifeng Huang, Cuiying Li, Jue Wang, Xiaoming Zha

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In one paragraph

Article in Journal of cancer research and clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Rui Chen *Breast Disease Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Hailing Zha *Ultrasound Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Qiannan Zhu *Breast Disease Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Xinpei LiuUltrasound Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Lifeng HuangBreast Disease Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Cuiying LiUltrasound Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. lynx_ko@163.com.
Jue WangBreast Disease Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. wangjue200011@njmu.edu.cn.
Xiaoming ZhaBreast Disease Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. njzhaxm@njmu.edu.cn.ORCID https://orcid.org/0000-0003-2604-811X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate assessment of axillary lymph node status after neoadjuvant systemic therapy (NST) is essential for de-escalating surgery in node-positive breast cancer. Although various axillary surgeries based on sentinel lymph node biopsy (SLNB) are widely reported, they still have limitations in this setting. Since metastatic lymph nodes inherently encompass sentinel nodes, we hypothesized that directly marking and retrieving these nodes could enable reliable restaging without SLNB. MATERIALS AND

methodsIn this single-arm, prospective cohort study, patients with pathologically confirmed axillary metastasis underwent ultrasound-guided injection of carbon nanoparticle suspension into the most suspicious lymph node(s) before NST. After completing NST, stained region lymph node biopsy (SrLNB) was performed to retrieve the marked nodes, followed by completion axillary lymph node dissection (ALND), without performing SLNB. The detection rate and false-negative rate (FNR) of SrLNB were evaluated to determine its feasibility.

resultsBetween September 2020 and December 2022, 159 patients were included. The axillary pathological complete response (pCR) rate was 40.9% (65/159). SrLNB achieved a detection rate of 100% (159/159) and an overall FNR of 5.3% (5/94). The FNR remained within the 10% safety threshold across all patient subgroups.

conclusionSrLNB is a feasible, economical, and straightforward technique for assessing axillary response after NST. With its high detection rate and acceptable FNR, SrLNB represents an alternative SLNB-independent strategy for axillary restaging in patients with initially node-positive breast cancer.

Indexed as

Breast NeoplasmsLymph NodesAdultAgedAxillaCohort StudiesFemaleHumansLymphatic MetastasisLymph Node ExcisionMiddle AgedNeoadjuvant TherapyNeoplasm StagingPathologic Complete ResponseProspective StudiesSentinel Lymph Node BiopsyBreast cancerNeoadjuvant systemic therapySentinel lymph node biopsyStained region lymph node biopsy

Identifiers

PMID42365133
PMCPMC13572350

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