Evidence map›Paper›PMID 42420636›Full record

ArticleAnnals of surgical oncology2026

Impact of Total and Positive Lymph Node Count on Recurrence in Young Women with Node-Positive Breast Cancer Undergoing Neoadjuvant Chemotherapy.

Lucy Zhang, Shama Birla, Sophia X Tang, Olivia W Galloway, Sydney Kinkade, Ariana Naaseh, Omolade O Sogade, Julie A Margenthaler

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Article in Annals of surgical oncology, 2026. 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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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Lucy ZhangSection of Surgical Oncology, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Shama BirlaSection of Surgical Oncology, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Sophia X TangSection of Surgical Oncology, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Olivia W GallowaySection of Surgical Oncology, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Sydney KinkadeSection of Surgical Oncology, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Ariana NaasehSection of Surgical Oncology, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Omolade O SogadeSection of Surgical Oncology, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Julie A MargenthalerSection of Surgical Oncology, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA. jmargenthaler@wustl.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAxillary management after neoadjuvant chemotherapy (NAC) in node-positive breast cancer remains controversial. This study assessed the association between total lymph node count, in the context of metastatic lymph node count and lymph node ratio (LNR), and recurrence after NAC in a cohort of young women with node-positive breast cancer.

methodsRetrospective data were analyzed from 274 women aged ≤ 45 years diagnosed with clinical T1-3, N1-3, M0 invasive breast cancer between January 2010 and December 2023 who received NAC before undergoing surgery at our institution. Primary outcomes were recurrence and overall survival. Total lymph node counts across three LNR tiers were compared between women with at least one metastatic node out of at least three retrieved nodes who did and did not develop recurrence.

resultsPatients who developed a recurrence presented with more advanced clinical T (p < 0.001) and N (p = 0.01) staging and had greater residual burden of disease in both the breast (p < 0.001) and the lymph nodes (p < 0.001) than did patients with no recurrence. There was no significant correlation between total number of lymph nodes excised and recurrence in women with at least one metastatic node out of at least three examined nodes in any of the low (p = 0.39), intermediate (p = 0.47), or high (p = 0.67) LNR tiers.

conclusionTumor biology, chemoresistance, and residual tumor burden after NAC may influence oncologic outcomes more than the number of nodes removed or the extent of nodal surgery. Prospective, large-scale, long-term studies are needed to rigorously address this question, particularly in this young, high-risk population.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsLymph NodesNeoadjuvant TherapyNeoplasm Recurrence, LocalAdultChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansLymphatic MetastasisPrognosisRetrospective StudiesSurvival RateBreast cancerLymph node ratioNeoadjuvant chemotherapyYoung women

Identifiers

PMID42420636

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