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Among the surgeons participating in the present survey, breast surgeons (38.6%) were less likely to perform axillary lymph node dissection (ALND) in early stage patients with a 1\u20132 positive sentinel lymph node biopsy (SLNB) with micro- or macrometastases, as opposed to those who defined themselves as general surgeons (ALND; 36.8% vs. 63.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015).\u00a0Almost all surgeons suggested neoadjuvant chemotherapy (NAC) for patients presenting with T4 (94.8%) or N2-3 disease (92.0%), whereas almost half of the surgeons (40.5%) always proceeded with NAC in patients with clinically node-positive cN1 breast cancer. Overall, 86.1% of surgeons performed SLNB in patients whose axilla became clinically negative after NAC. More than half of the surgeons (55.2%) preferred blue dye as the SLNB technique and 37 (42.5%) used the combined method. Among 87 surgeons, 24.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921) always, 39.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934) sometimes, and 36.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932) never preferred clip marking of axillary metastatic lymph nodes before NAC, whereas 56.4% performed targeted axillary dissection (TAD) after NAC. In cN+ patients before NAC, the majority of surgeons (74.3%) did not perform ALND in patients with at least three lymph nodes removed and SLNB negative. Of note, more than half of the surgeons (51.5%) did not perform ALND in the presence of isolated tumor cells or micrometastases among the three SLNs as long as regional nodal irradiation was received. However, 54.5% of the patients routinely underwent ALND in the presence of macrometastatic residual nodal disease after NAC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Deescalating strategies in axillary surgery have been increasing in both initially clinically node-negative and-positive breast cancers as long as nodal radiation is provided.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-025-03767-9","type":"journal-article","created":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T23:50:52Z","timestamp":1750031452000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Changing practice patterns in axillary management for patients with node-positive breast cancer towards increased use of sentinel lymph node biopsy-alone after neoadjuvant chemotherapy: results of a survey (MF17-01) among Turkish surgeons"],"prefix":"10.1007","volume":"410","author":[{"given":"Neslihan","family":"Cab\u0131o\u011flu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damla Okan","family":"Ercan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130rem","family":"Karata\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erhan","family":"Er\u00f6z","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safa","family":"Toprak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selman","family":"Emiro\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elnur","family":"H\u00fcseynov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enver","family":"\u00d6zkurt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baran","family":"Mollavelio\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"T\u00fckenmez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmut","family":"M\u00fcsl\u00fcmano\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"\u0130\u011fci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vahit","family":"\u00d6zmen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"3767_CR1","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1056\/NEJMoa020128","volume":"347","author":"B Fisher","year":"2002","unstructured":"Fisher B, Jeong JH, Anderson S, Bryant J, Fisher ER, Wolmark N (2002) Twenty-five year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. 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Informed consent was obtained from all the participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"196"}}