{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:07:19Z","timestamp":1788952039070,"version":"build-2803163510"},"reference-count":28,"publisher":"Elsevier BV","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinical-breast-cancer.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Breast Cancer"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.clbc.2026.07.032","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:19:18Z","timestamp":1785424758000},"page":"137-144","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of Targeted Axillary Dissection in Clinically Node-Positive Breast Cancer: Adoption Trends and Comparative Outcomes at a Single Institution"],"prefix":"10.1016","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8210-9512","authenticated-orcid":false,"given":"Skylar","family":"Harbour","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Ki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0380-8715","authenticated-orcid":false,"given":"Victoria","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheldon","family":"Feldman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Ravetch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8879-6455","authenticated-orcid":false,"given":"Ruth","family":"Samson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"McEvoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"22","key":"10.1016\/j.clbc.2026.07.032_bib0001","doi-asserted-by":"crossref","first-page":"4085","DOI":"10.1002\/cam4.4769","article-title":"Diagnostic accuracy of de-escalated surgical procedure in axilla for node-positive breast cancer patients treated with neoadjuvant systemic therapy: a systematic review and meta-analysis","volume":"11","author":"Song","year":"2022","journal-title":"Cancer Med"},{"issue":"14","key":"10.1016\/j.clbc.2026.07.032_bib0002","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1001\/jama.2013.278932","article-title":"Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial","volume":"310","author":"Boughey","year":"2013","journal-title":"JAMA"},{"issue":"7","key":"10.1016\/j.clbc.2026.07.032_bib0003","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/S1470-2045(13)70166-9","article-title":"Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study","volume":"14","author":"Kuehn","year":"2013","journal-title":"Lancet Oncol"},{"issue":"4","key":"10.1016\/j.clbc.2026.07.032_bib0004","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1097\/SLA.0000000000005671","article-title":"Impact of axillary lymph node dissection and sentinel lymph node biopsy on upper limb morbidity in breast cancer patients: a systematic review and meta-analysis","volume":"277","author":"Che Bakri","year":"2023","journal-title":"Ann Surg"},{"issue":"7","key":"10.1016\/j.clbc.2026.07.032_bib0005","doi-asserted-by":"crossref","first-page":"4477","DOI":"10.1245\/s10434-024-15182-3","article-title":"Implementation of the targeted axillary dissection procedure in clinically node-positive breast cancer: a retrospective analysis","volume":"31","author":"Nijveldt","year":"2024","journal-title":"Ann Surg Oncol"},{"issue":"8","key":"10.1016\/j.clbc.2026.07.032_bib0006","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1001\/jamasurg.2023.1772","article-title":"Safety of targeted axillary dissection after neoadjuvant therapy in patients with node-positive breast cancer","volume":"158","author":"Kuemmel","year":"2023","journal-title":"JAMA Surg"},{"issue":"11","key":"10.1016\/j.clbc.2026.07.032_bib0007","doi-asserted-by":"crossref","first-page":"7264","DOI":"10.1245\/s10434-024-15797-6","article-title":"Residual nodal burden after neoadjuvant chemotherapy in cN1 breast cancer patients with positive nodes at targeted axillary dissection","volume":"31","author":"Moore","year":"2024","journal-title":"Ann Surg Oncol"},{"issue":"10","key":"10.1016\/j.clbc.2026.07.032_bib0008","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1200\/JCO.2015.64.0094","article-title":"Improved axillary evaluation following neoadjuvant therapy for patients with node-positive breast cancer using selective evaluation of clipped nodes: implementation of targeted axillary dissection","volume":"34","author":"Caudle","year":"2016","journal-title":"J Clin Oncol"},{"issue":"5","key":"10.1016\/j.clbc.2026.07.032_bib0009","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.2214\/AJR.13.12311","article-title":"Role of sonography for the locoregional staging of breast cancer","volume":"203","author":"Lane","year":"2014","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.clbc.2026.07.032_bib0010","unstructured":"National Comprehensive Cancer Network. National Comprehensive Cancer Network, Inc. 2025; 2025. Available at: Accessed October 12, 2025. http:\/\/www.Nccn.org."},{"issue":"11","key":"10.1016\/j.clbc.2026.07.032_bib0011","doi-asserted-by":"crossref","first-page":"6401","DOI":"10.1245\/s10434-023-13759-y","article-title":"Changes in surgical management of the axilla over 11 years\u2014report on more than 1500 breast cancer patients treated with neoadjuvant chemotherapy on the prospective I-SPY2 trial","volume":"30","author":"Boughey","year":"2023","journal-title":"Ann Surg Oncol"},{"issue":"3","key":"10.1016\/j.clbc.2026.07.032_bib0012","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.surg.2023.08.039","article-title":"Axillary management in breast cancer after neoadjuvant chemotherapy in the modern era: a national cancer database analysis","volume":"175","author":"Whitrock","year":"2024","journal-title":"Surgery"},{"issue":"13","key":"10.1016\/j.clbc.2026.07.032_bib0013","doi-asserted-by":"crossref","first-page":"8813","DOI":"10.1245\/s10434-024-16143-6","article-title":"Omission of axillary lymph node dissection in patients with residual nodal disease after neoadjuvant chemotherapy","volume":"31","author":"Limberg","year":"2024","journal-title":"Ann Surg Oncol"},{"issue":"10","key":"10.1016\/j.clbc.2026.07.032_bib0014","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1001\/jama.2017.11470","article-title":"Effect of axillary dissection vs No axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (alliance) randomized clinical trial","volume":"318","author":"Giuliano","year":"2017","journal-title":"JAMA"},{"issue":"2","key":"10.1016\/j.clbc.2026.07.032_bib0015","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/SLA.0000000000000558","article-title":"Marking axillary lymph nodes with radioactive iodine seeds for axillary staging after neoadjuvant systemic treatment in breast cancer patients: the MARI procedure","volume":"261","author":"Donker","year":"2015","journal-title":"Ann Surg"},{"key":"10.1016\/j.clbc.2026.07.032_bib0016","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s10549-019-05520-5","article-title":"Axillary management for young women with breast cancer varies between patients electing breast-conservation therapy or mastectomy","volume":"180","author":"Tadros","year":"2020","journal-title":"Breast Cancer Res Treat"},{"key":"10.1016\/j.clbc.2026.07.032_bib0017","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2021.0891","article-title":"Axillary pathologic complete response after neoadjuvant systemic therapy by breast cancer subtype in patients with initially clinically node-positive disease: a systematic review and meta-analysis","volume":"156","author":"Samiei","year":"2021","journal-title":"JAMA Surg"},{"issue":"3","key":"10.1016\/j.clbc.2026.07.032_bib0018","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1097\/SLA.0000000000003075","article-title":"Diagnostic accuracy of different surgical procedures for axillary staging after neoadjuvant systemic therapy in node-positive breast cancer: a systematic review and meta-analysis","volume":"269","author":"Simons","year":"2019","journal-title":"Ann Surg"},{"key":"10.1016\/j.clbc.2026.07.032_bib0019","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1200\/JCO.22.01565","article-title":"Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer: 10-year results of the randomized controlled EORTC 10981-22023 AMAROS trial","volume":"41","author":"Bartels","year":"2023","journal-title":"J Clin Oncol"},{"issue":"suppl 3","key":"10.1016\/j.clbc.2026.07.032_bib0020","doi-asserted-by":"crossref","first-page":"S234","DOI":"10.1097\/SAP.0000000000001864","article-title":"Lymphedema incidence after axillary lymph node dissection: quantifying the impact of radiation and the lymphatic microsurgical preventive healing approach","volume":"82","author":"Johnson","year":"2019","journal-title":"Ann Plast Surg"},{"issue":"11","key":"10.1016\/j.clbc.2026.07.032_bib0021","doi-asserted-by":"crossref","first-page":"6506","DOI":"10.1245\/s10434-023-13730-x","article-title":"Temporal trends and factors associated with receipt of post-mastectomy radiation after neoadjuvant chemotherapy in women with cT3 breast cancer","volume":"30","author":"Manik","year":"2023","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"10.1016\/j.clbc.2026.07.032_bib0022","doi-asserted-by":"crossref","first-page":"285","DOI":"10.4048\/jbc.2019.22.e25","article-title":"The benefit of post-mastectomy radiotherapy in ypN0 patients after neoadjuvant chemotherapy according to molecular subtypes","volume":"22","author":"Cho","year":"2019","journal-title":"J Breast Cancer"},{"issue":"2","key":"10.1016\/j.clbc.2026.07.032_bib0023","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.59692","article-title":"Trends in axillary lymph node dissection after mastectomy among patients with limited nodal burden","volume":"8","author":"Wang","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"5","key":"10.1016\/j.clbc.2026.07.032_bib0024","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.breast.2006.01.006","article-title":"Two-step axillary operation increases risk of arm morbidity in breast cancer patients","volume":"15","author":"Husen","year":"2006","journal-title":"Breast"},{"issue":"4","key":"10.1016\/j.clbc.2026.07.032_bib0025","article-title":"Targeted axillary dissection in node-positive breast cancer: a retrospective study and cost analysis","volume":"13","author":"Beniey","year":"2021","journal-title":"Cureus"},{"key":"10.1016\/j.clbc.2026.07.032_bib0026","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1097\/SLA.0000000000001375","article-title":"Identification and resection of clipped node decreases the false-negative rate of sentinel lymph node surgery in patients presenting with node-positive breast cancer (T0-T4, N1-N2) who receive neoadjuvant chemotherapy: results from ACOSOG Z1071 (Alliance)","volume":"263","author":"Boughey","year":"2016","journal-title":"Ann Surg"},{"issue":"13","key":"10.1016\/j.clbc.2026.07.032_bib0027","doi-asserted-by":"crossref","first-page":"8037","DOI":"10.1245\/s10434-022-12238-0","article-title":"Omission of intraoperative frozen section may reduce axillary overtreatment among clinically node-negative patients having upfront mastectomy","volume":"29","author":"Williams","year":"2022","journal-title":"Ann Surg Oncol"},{"issue":"Suppl 2","key":"10.1016\/j.clbc.2026.07.032_bib0028","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s12262-013-0827-2","article-title":"Intraoperative frozen section evaluation of sentinel lymph nodes in breast carcinoma: single-institution indian experience","volume":"77","author":"Somashekhar","year":"2015","journal-title":"Indian J Surg"}],"container-title":["Clinical Breast Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1526820926001321?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1526820926001321?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:08:28Z","timestamp":1788948508000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1526820926001321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["S1526820926001321"],"URL":"https:\/\/doi.org\/10.1016\/j.clbc.2026.07.032","relation":{},"ISSN":["1526-8209"],"issn-type":[{"value":"1526-8209","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Implementation of Targeted Axillary Dissection in Clinically Node-Positive Breast Cancer: Adoption Trends and Comparative Outcomes at a Single Institution","name":"articletitle","label":"Article Title"},{"value":"Clinical Breast Cancer","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clbc.2026.07.032","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}