Optimizing Axillary Management in Triple-Negative Breast Cancer Following Neoadjuvant Chemotherapy.

Authors

Samir Mitri, Laura Martin Manfroi, Prabh R Pannu, Jessica Means, Estefania Roldan-Vasquez, Giulia Borgonovo, Tarbia Hamid, Hiral Thakkar, Roger B Davis, Ted A James

Published in

Clinical breast cancer. Mar 31, 2025. Epub Mar 31, 2025.

Abstract

Triple-negative breast cancer (TNBC) often shows significant response to neoadjuvant chemotherapy (NACT), creating opportunities for axillary de-escalation. This study investigates axillary de-escalation and the factors influencing its use in TNBC.
Patients with cT1-cT2, cN1 TNBC treated between 2012 and 2020 were identified from the National Cancer Database. Nodal response rates, including achievement of ypN0, were analyzed. Logistic regression identified clinical and sociodemographic factors associated with axillary management.
Among 12,742 patients undergoing axillary lymph node dissection (ALND), 31.7% achieved nodal pathologic complete response (pCR). These patients were more also likely to achieve breast tumor pCR. Treatment across multiple facilities was associated with a higher likelihood of attempted axillary de-escalation. ALND rates steadily declined between 2014 and 2020.
Despite achieving nodal pCR after NACT, many patients with TNBC underwent ALND. These findings underscore the need to refine criteria and increase adoption of axillary de-escalation strategies in TNBC.

PMID:
40288933
Bibliographic data and abstract were imported from PubMed on 28 Apr 2025.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.