{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T09:16:02Z","timestamp":1780478162828,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T00:00:00Z","timestamp":1751760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We sought to evaluate whether patients with breast cancer who undergo a total mastectomy (TM) can safely forgo a completion axillary lymph node dissection (cALND) in the presence of one to three positive sentinel lymph nodes (SLN+).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter retrospective cohort study (2012\u20132022) was conducted in patients with cT1\u20103cN0 who underwent TM with 1\u20133 SLN+ compared by cALND versus. no further surgery. We compared overall survival (OS) and locoregional recurrence rates (LRR) and investigated whether the omission of cALND altered adjuvant treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, the study included 139 patients with SLN+TM, with a mean tumor size of 19.44\u00a0mm (SD:10.64); 76% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0105) of these patients underwent SLNB\u2010alone. Patients treated by cALND had a younger mean age than those treated by SLNB\u2010alone (49.5 vs. 56\u00a0years and <jats:italic>p<\/jats:italic>\u00a0=\u00a00.016). Patients undergoing cALND were more likely to have macrometastatic disease (97% vs. 65% and <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and extranodal extension (47% vs. 29% and <jats:italic>p<\/jats:italic>\u00a0=\u00a00.046). cALND was associated with higher rates of adjuvant chemotherapy (88% vs. 62% and <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004). Postmastectomy radiotherapy (PMRT) was similar between groups (79% vs. 82% and <jats:italic>p<\/jats:italic>\u00a0=\u00a00.68). At a mean follow\u2010up of 5.2\u00a0years, there was one chest\u2010wall LRR in the SLNB group, with no axillary recurrences. LRR did not significantly differ with or without cALND (2.9% vs. 1.0% and <jats:italic>p\u00a0=<\/jats:italic>\u00a00.4). Five\u2010year overall survival rates were similar between groups (100% vs. 94% and <jats:italic>p<\/jats:italic>\u00a0=\u00a00.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found high OS and low LRR among patients undergoing upfront TM with 1\u20133 SLN+\u00a0without cALND. Completion ALND did not decrease receipt of PMRT but was associated with higher rates of adjuvant chemotherapy. Our findings support the omission of cALND after TM for patients with 1\u20133 SLN+.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12690","type":"journal-article","created":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T23:38:16Z","timestamp":1751845096000},"page":"2083-2091","source":"Crossref","is-referenced-by-count":1,"title":["Axillary Management for Patients Undergoing Total Mastectomy and a Positive Sentinel Lymph Node: Is Axillary Dissection Necessary?"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9726-7930","authenticated-orcid":false,"given":"Miranda","family":"Addie","sequence":"first","affiliation":[{"name":"Division of Surgical and Interventional Science Department of Surgery McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander\u2010Darius","family":"Miron","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Universit\u00e9 de Montr\u00e9al  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ericka","family":"Iny","sequence":"additional","affiliation":[{"name":"McGill University Medical School  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basmah","family":"Alhassan","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Department of Surgery McGill University Health Centre  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Ferroum","sequence":"additional","affiliation":[{"name":"McGill University Medical School  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie M.","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Surgical and Interventional Science Department of Surgery McGill University  Montreal Canada"},{"name":"Segal Cancer Centre Sir Mortimer B. Davis Jewish General Hospital  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ipshita","family":"Prakash","sequence":"additional","affiliation":[{"name":"Division of Surgical and Interventional Science Department of Surgery McGill University  Montreal Canada"},{"name":"Segal Cancer Centre Sir Mortimer B. Davis Jewish General Hospital  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Hijal","sequence":"additional","affiliation":[{"name":"Department of Oncology Division of Radiation Oncology McGill University Health Centre  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarkis","family":"Meterissian","sequence":"additional","affiliation":[{"name":"Division of Surgical and Interventional Science Department of Surgery McGill University  Montreal Canada"},{"name":"Department of Oncology &amp; Department of Surgery McGill University Health Centre  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.90"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000001863"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2014.56.5838"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(13)70035\u20104"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(14)70460\u20107"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.22.01565"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2019.37.15_suppl.TPS602"},{"key":"e_1_2_10_9_1","unstructured":"Breast Cancer Atlas for Radiation Therapy Planning: Consensus Definitions https:\/\/www.srobf.cz\/downloads\/cilove\u2010objemy\/breastcanceratlas.pdf."},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2020.7597"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010015\u20104528\u2010x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0119105"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010018\u20106525\u20103"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2016.69.1188"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010024\u201015049\u20107"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2015.05.004"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2313487"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znad215"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010023\u201013942\u20101"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(18)30380\u20102"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010022\u201011866\u2010w"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181f08f32"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010016\u20105605\u20105"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znae077"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010054365"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1181069"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010021\u201006341\u20101"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.12690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T15:33:02Z","timestamp":1754926382000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.12690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,6]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/wjs.12690"],"URL":"https:\/\/doi.org\/10.1002\/wjs.12690","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,6]]}}}