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Neo-adjuvant chemotherapy and axillary de-escalation management for patients with clinically node-negative breast cancer

The Breast Journal Jul 28, 2019

Shi ZQ, et al. - Researchers sought for the optimal time of performing sentinel lymph node biopsy (SLNB) and providing neo-adjuvant chemotherapy (NAC) in clinically node-negative (cN0) patients. In addition, they evaluated the feasibility of selective elimination of axillary surgery after NAC in these patients. They performed a retrospective study including 845 patients undergoing surgery after NAC. The analysis revealed that for cN0 patients with different molecular subtypes, the optimal time of SLNB and NAC might be different: hormone receptor positive (HR+)/HER2− patients should preferably undergo SLNB prior to NAC, and triple-negative (TN) and HER2+ patients should preferably undergo SLNB after NAC to reduce the risk of axillary lymph node dissection. They noted a high ypN0 rate in cN0 patients, suggesting the possibility for the elimination of axillary surgical staging, especially for HER2+ and TN patients.
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