{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:28:44Z","timestamp":1787225324013,"version":"build-2736575974"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is no consensus on axillary management after neoadjuvant therapy (NAT) in patients with clinically node-positive (cN+) breast cancer. To investigate current clinical practice, an international survey was conducted among breast surgeons and radiation oncologists. The aim of the first part of the survey was to provide a snapshot of international discrepancies regarding axillary surgery in this context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The European Breast Cancer Research Association of Surgical Trialists (EUBREAST) developed a web-based survey containing 39 questions describing clinical scenarios in the setting of axillary management in patients with cN1 disease converting to ycN0 after NAT. The survey was then distributed to breast surgeons and radiation oncologists via 14 breast cancer societies between April and October 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Responses from 349 physicians in 45 countries were recorded. The most common post-NAT axillary surgery in patients with cN1 disease converting to ycN0 was targeted axillary dissection (54.2 per cent), followed by sentinel lymph node biopsy (SLNB) alone (20.9 per cent), level 1\u20132 axillary lymph node dissection (ALND) (18.4 per cent), level 1\u20133 ALND (4 per cent), and targeted lymph node biopsy (2.5 per cent). For SLNB alone, dual tracers were most commonly used (62.3 per cent). Management varied widely in patients with ambiguous axillary status before initiation of treatment or a residual metastatic burden in the axilla after NAT. In patients with ycN+ tumours, ALND was the preferred surgical approach for 66.8 per cent of respondents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results highlight the wide heterogeneity in surgical approaches to the axilla after NAT. To standardize the guidelines, further data from clinical research are urgently needed, which underlines the importance of the ongoing AXSANA (EUBREAST-3) study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znac217","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T06:34:21Z","timestamp":1656484461000},"page":"857-863","source":"Crossref","is-referenced-by-count":58,"title":["Axillary surgery after neoadjuvant therapy in initially node-positive breast cancer: international EUBREAST survey"],"prefix":"10.1093","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9482-9527","authenticated-orcid":false,"given":"Maria Luisa","family":"Gasparri","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano , Lugano, CH"},{"name":"Faculty of Biomedicine, University of the Italian Switzerland (USI) , Lugano , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9518-0902","authenticated-orcid":false,"given":"Jana","family":"de Boniface","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden"},{"name":"Department of Surgery, Capio St. G\u00f6ran's Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Poortmans","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Iridium Netwerk , Wilrijk-Antwerp , Belgium"},{"name":"Faculty of Medicine and Health Sciences, University of Antwerp , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oreste D","family":"Gentilini","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, San Raffaele University Hospital , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orit","family":"Kaidar-Person","sequence":"additional","affiliation":[{"name":"Breast Radiation Unit, Oncology Institute, Sheba Hospital Tel Hashomer , Ramat Gan , Israel"},{"name":"Sackler School of Medicine, Tel-Aviv University , Tel-Aviv , Israel"},{"name":"GROW-School for Oncology and Developmental Biology or GROW (Maastro), Maastricht University , Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Banys-Paluchowski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein Campus L\u00fcbeck , L\u00fcbeck , Germany"},{"name":"Medical Faculty, Heinrich-Heine-University D\u00fcsseldorf , D\u00fcsseldorf , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Di Micco","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, San Raffaele University Hospital , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0838-2918","authenticated-orcid":false,"given":"Laura","family":"Niinikoski","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, Comprehensive Cancer Center, Helsinki University Hospital, University of Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Murawa","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Surgical Oncology, Collegium Medicum, University of Zielona G\u00f3ra , Zielona G\u00f3ra , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard Alexandru","family":"Bonci","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, \u201cProf. Dr. Ion Chiricu\u021b\u0103\u201d Institute of Oncology , Cluj-Napoca, Romania"},{"name":"Department of Oncological Surgery and Gynecological Oncology, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy , Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0726-6381","authenticated-orcid":false,"given":"Andrei","family":"Pasca","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, \u201cProf. Dr. Ion Chiricu\u021b\u0103\u201d Institute of Oncology , Cluj-Napoca, Romania"},{"name":"Department of Oncological Surgery and Gynecological Oncology, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy , Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0035-0679","authenticated-orcid":false,"given":"Isabel T","family":"Rubio","sequence":"additional","affiliation":[{"name":"Breast Surgical Unit, Cl\u00ednica Universidad de Navarra , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guldeniz","family":"Karadeniz Cakmak","sequence":"additional","affiliation":[{"name":"Zonguldak BEUN The School of Medicine, General Surgery Department, Breast and Endocrine Unit , Kozlu\/Zonguldak, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michalis","family":"Kontos","sequence":"additional","affiliation":[{"name":"1st Department of Surgery, Laiko Hospital, National and Kapodistrian University of Athens , Athens , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8708-2824","authenticated-orcid":false,"given":"Thorsten","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Interdisciplinary Breast Center, Department of Gynecology and Obstetrics , Klinikum Esslingen, Esslingen , 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