{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:10:59Z","timestamp":1780657859288,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Both domestic and international guidelines recommend using dual tracers and retrieving at least three sentinel lymph nodes (SLNs) for SLN biopsy (SLNB) in patients who are downstaged from clinical N1 lymph node status (cN1) to clinical N0 status after neoadjuvant therapy (NAT). However, because of various limitations, most hospitals in China still perform SLNB using a single blue dye. This discrepancy between guidelines and real\u2010world practice warrants further reflection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult women who had clinical cT1\u2013cT4, cN1, M0 breast cancer scheduled who were for NAT were eligible. After NAT, patients underwent sequential SLNB and axillary lymph node dissection, with SLNs identified using single dye. The primary end point was the false\u2010negative rate (FNR) of single\u2010dye SLNB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 432 patients from 12 centers, single\u2010dye SLNB succeeded in 393 of 432 (90.97%). Pathology revealed node metastases in 201 of 393 patients. The FNR was 8.96% (18 of 201 patients; 95% upper confidence limit, 12.02%). The FNR was lower in women aged 60 years and younger (3.80% vs. 27.91%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001), and in those with a body mass index (BMI) &lt;25 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (4.20% vs. 14.47%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0151), with four or more SLNs (5.19% vs. 16.67%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0152), and with estrogen receptor\u2010negative tumors (3.52% vs. 12.93%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0242). BMI \u226525 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (odds ratio, 5.68; 95% confidence interval, 2.05\u201318.33;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0006), estrogen receptor\u2010positive tumors (odds ratio, 3.49; 95% confidence interval, 1.15\u201312.72;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0264) were independently associated with a false\u2010negative SLNB. Examining a greater number of SLNs was independently associated with a lower FNR (odds ratio, 0.65; 95% confidence interval, 0.45\u20130.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=.0088). In hormone receptor\u2010negative\/human epidermal growth factor receptor\u2013positive patients, the FNR was 0%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Single\u2010dye SLNB after NAT in patients initially diagnosed with cN1 breast cancer yielded a clinically acceptable FNR. When four or more SLNs were identified, an additional benefit was observed in patients who had a BMI &lt;25 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and negative estrogen receptor status.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70298","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T16:58:56Z","timestamp":1771088336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sentinel lymph node biopsy using dye alone in patients with initial clinical N1 breast cancer receiving neoadjuvant therapy: A multicenter diagnostic trial (Northern Breast Cancer Collaboration Group NBCG\u2010002)"],"prefix":"10.1002","volume":"132","author":[{"given":"Lei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Breast Surgery The First Hospital of China Medical University  Shenyang Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0325-5362","authenticated-orcid":false,"given":"Ang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery The First Hospital of China Medical University  Shenyang Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery The First Hospital of China Medical University  Shenyang Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery The First Hospital of China Medical University  Shenyang Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dian\u2010Long","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery Affiliated Zhongshan Hospital of Dalian University  Dalian Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery Liaoning Cancer Hospital and Institute  Shenyang Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of General Surgery The Second Affiliated Hospital of Harbin Medical University  Harbin Heilongjiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery The First Hospital of China Medical University  Shenyang Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Ma","sequence":"additional","affiliation":[{"name":"Breast Center The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Fen","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery The First Affiliated Hospital of Zhejiang University  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery Institute of Breast Disease The Second Hospital of Dalian Medical University  Dalian Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010Yun","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery Yunnan Cancer Hospital The Third Affiliated Hospital of Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai\u2010Ping","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery The First Hospital of Jilin University  Changchun Jilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bao\u2010Liang","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of General Surgery The Second Affiliated Hospital of Harbin Medical University  Harbin Heilongjiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery The First Hospital of China Medical University  Shenyang Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2216-2794","authenticated-orcid":false,"given":"Bo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery The First Hospital of China Medical University  Shenyang Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000003075"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.4935"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0891"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2016.71.0947"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.0030"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13071565"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.19.02576"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(13)70166\u20109"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.278932"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2014.55.7827"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010017\u20104164\u20101"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.4163"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/cm9.0000000000001410"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000001375"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0204364"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/cm9.0000000000001359"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2024.101315"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.19538\/j.cjps.issn1005\u20102208.2018.08.04"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.21.02439"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(10)70207\u20102"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.233051"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1047"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010018\u20105004\u20107"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2016.07.018"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0b013e3181b8fd5e"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.13123"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.3759"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2412063"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70298","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.70298","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T10:32:48Z","timestamp":1780655568000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.70298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,14]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,2,15]]}},"alternative-id":["10.1002\/cncr.70298"],"URL":"https:\/\/doi.org\/10.1002\/cncr.70298","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,14]]},"assertion":[{"value":"2025-08-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70298"}}