ArticleBritish journal of cancer2026
On-treatment core needle biopsy identifies early responders for axillary surgery de-escalation: results from a prospective cohort.
Article in British journal of cancer, 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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Authors and funding
8 authors.
Funding
Abstract
backgroundIncreasing axillary pathologic complete response (pCR) rates after neoadjuvant chemotherapy (NACT) challenge the need for routine axillary surgery. On-treatment core needle biopsy (CNB) can assess early response, but its predictive and prognostic value for axillary surgery de-escalation remains unclear.
methodsThis prospective cohort included breast cancer patients receiving on-treatment CNB (after 2-4 cycles) of the primary tumor during NACT (2013-2021). Early responders were defined as having no residual disease of on-treatment CNB. These results were compared with axillary pCR and survival outcomes.
resultsThe overall axillary pCR rate of 1693 patients was 54.3%. Of 500 early responders, 83.4% achieved axillary pCR. In clinically node-negative (cN0) patients, 98.0% (99/101) of those early responders presented with no nodal disease. While 79.7% of cN+ early responders achieved axillary pCR, this rate increased to 89.6% when combined with post-treatment MRI complete response (92.6% in cN1 and 90.0% in cN2 patients). Survival analysis revealed early responders with superior five-year overall and event-free survival with HR-negative tumors (p < 0.001).
conclusionsOn-treatment CNB reliably identifies patients likely to achieve axillary pCR, offering an approach to guide de-escalation strategies and potentially identifying patients who may benefit from tailored systemic and surgical treatments.
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