Barrio AV, Montagna G, Mamtani A, et al. - Researchers investigated nodal recurrence rates in patients with clinically node-positive (cN1) breast cancer treated with sentinel lymph node biopsy (SLNB) alone after neoadjuvant chemotherapy (NAC).

• This study included a cohort of consecutively identified 610 patients with cT1 to cT3 biopsy-proven N1 breast cancer rendered cN0 by NAC.

• Participants had SLNB with dual tracer mapping and omission of ALND if 3 or more SLNs were identified and all were pathologically negative.

• Cancer in 234 consecutive patients was rendered cN0 with NAC treated with SLNB alone with 3 or more negative SLNs retrieved; rates of axillary failure among these patients were low (0.4%) at a median follow-up of 40 months, without routine nodal clipping.

• In patients with cN1 breast cancer who achieve nodal pathologic complete response with NAC and are treated with SLNB alone, omission of axillary lymph node dissection can be done.