{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T21:38:18Z","timestamp":1765057098344,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The current study aimed to determine whether results could justify whether axillary lymph node dissection (ALND) could be further de\u2010escalated in selected patients having neoadjuvant chemotherapy (NAC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analyses were performed for breast cancer patients treated with NAC from 2015 to 2023. Abnormal axillary nodes evaluated by pretreatment ultrasound had core biopsies with microclip placement. Patients assigned to ALND had histologically positive SLND (ypN+), were clinically node\u2010positive (ycN+) post\u2010NAC, did not map, or did not have a clipped node retrieved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 274 predominantly Hispanic (78%) patients, the median age was 51 years, and the follow\u2010up was 38.1 months. Of 198 pN+ patients, 120 were clinically node\u2010negative (ycN0) post\u2010NAC and had wire\u2010directed (WD) SLND, whereas 78 were ycN+ and had planned ALND. Sixty percent of pN+ patients converted to ypN0 post\u2010NAC. Fifty\u2010eight percent of patients with ypN+ status had additional positive non\u2010sentinel lymph nodes in the ALND specimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ALND was avoided in approximately half of patients who presented with axillary node metastases and became ycN0 post\u2010NAC. Response to NAC correlated with node status at surgery. Patients who do not map may not need ALND if a pN+ clipped node is retrieved and converts to ypN0.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.70070","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T14:14:23Z","timestamp":1755785663000},"page":"853-859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Factors Associated With Residual Positive Lymph Nodes With Targeted Axillary Lymph Node Dissection for Breast Cancer and Accuracy of Clipped Node Retrieval in Non\u2010Mapping Patients"],"prefix":"10.1002","volume":"132","author":[{"given":"Danielle E.","family":"Brabender","sequence":"first","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexa","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaye A.","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria E.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumito","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azadeh A.","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily L.","family":"Siegel","sequence":"additional","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen F.","family":"Sener","sequence":"additional","affiliation":[{"name":"Department of Surgery Los Angeles General Medical Center Los Angeles California USA"},{"name":"Department of Surgery and Norris Comprehensive Cancer Center, Keck School of Medicine of USC University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0891"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08650-z"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.278932"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70166-9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.7827"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-018-5004-7"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.0094"},{"key":"e_1_2_7_9_1","unstructured":"\u201cNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae). Breast Cancer: Version 1.2025\u2010January 31 2025. Invasive Breast Cancer>Considerations for Axillary Staging (BINV\u2010D) p45\/262 \u201d National Comprehensive Cancer Network accessed February 5 2025 https:\/\/www.nccn.org\/patients."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2024.108245"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.1772"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27241"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2024.0578"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-15792-x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-025-07668-9"},{"key":"e_1_2_7_16_1","unstructured":"\u201cNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae). Breast Cancer Version 2.2022\u2010December 20 2021. Invasive Breast Cancer>Principles of Preoperative Systemic Therapy (BINV\u2010M) pp. 70 and 71\/244 \u201d National Comprehensive Cancer Network accessed March 22 2022 www.nccn.org\/patients."},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2004.01.006"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70278-4"},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","unstructured":"J. C.Boughey V.Suman K. J.Hunt et al. \u201cFactors Influencing Additional Nodal Disease and Pathologic Nodal Upstaging With Axillary Dissection in Patients With Residual Node\u2010Positive Breast Cancer After Neoadjuvant Chemotherapy Enrolled on Alliance 011202 Clinical Trial \u201d Abstr. 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