ASO Author Reflections: Nodal Recurrence Is Rare in Patients with cN+/ycN0 Breast Cancer after Neoadjuvant Chemotherapy Regardless of the Extent of Axillary Surgery or Nodal Pathology in the NEOSENTITURK-Trials MF18-02/18-03 Provided Regional Nodal Irradiation Is Administered

Ann Surg Oncol. 2025 Feb;32(2):971-972. doi: 10.1245/s10434-024-16651-5. Epub 2024 Dec 9.

Abstract

The combined analysis of the retrospective multicentre and prospective multicenter cohort registry trial NEOSENTITURK MF18-02/18-03 (NCT04250129) investigated the outcomes and factors associated with recurrence in patients with cT1-4N1-3M0 who underwent a succesful sentinel lymph node biopsy or targeted axillary dissection (n = 1470), with or without axillary lymph node dissection (n = 937) after neoadjuvant chemotherapy. The present large registry data suggest that axillary recurrences (AR) can be detected at exceedingly low rates (< 0.5%) within 3 years after surgery. This is regardless of the extent of axillary surgery or nodal pathology, provided that regional nodal irradiation is administered. Factors associated with increased risk for AR included age under 45 years, nonpathologic complete response (non-pCR) in the breast, and nonluminal pathology. Similarly, having cT3-4, a non-pCR in the breast or axilla, and nonluminal pathology were identified as poor prognostic factors.

Keywords: Axillary lymph node dissection; Breast cancer recurrence; Neoadjuvant chemotherapy; Nodal recurrence; Nonluminal pathology; Regional nodal irradiation; Sentinel lymph node biopsy; Survival; Young age.

Publication types

  • Multicenter Study

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Axilla* / surgery
  • Breast Neoplasms* / pathology
  • Breast Neoplasms* / radiotherapy
  • Breast Neoplasms* / therapy
  • Chemotherapy, Adjuvant*
  • Female
  • Follow-Up Studies
  • Humans
  • Lymph Node Excision
  • Lymph Nodes* / pathology
  • Lymph Nodes* / radiation effects
  • Lymphatic Metastasis
  • Middle Aged
  • Neoadjuvant Therapy*
  • Neoplasm Recurrence, Local* / pathology
  • Neoplasm Recurrence, Local* / therapy
  • Prognosis
  • Prospective Studies
  • Registries
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy
  • Survival Rate