{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:23:28Z","timestamp":1790832208925,"version":"4.1.0"},"reference-count":33,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2002,3,1]]},"abstract":"<jats:p> PURPOSE: To determine the incidence and prognostic significance of eradication of cytologically proven axillary lymph node metastases in breast cancer patients treated with primary chemotherapy. <\/jats:p><jats:p> PATIENTS AND METHODS: Between January 1985 and December 1994, 152 breast cancer patients with invasive T1 to T3 tumors and axillary metastases cytologically proven by fine-needle sampling underwent primary chemotherapy followed by lumpectomy or mastectomy, level I and II axillary lymph node dissection, and irradiation. We studied pathologic complete responses (pCRs) of axillary nodes and breast tumors, as well as predictors of distant metastases. <\/jats:p><jats:p> RESULTS: Thirty-five patients (23%) had axillary pCRs, and 20 patients (13.2%) had pCRs of primary breast tumors. Scarff-Bloom-Richardson grade 3 tumors (P = .04) and a clinical response to chemotherapy \u2265 50% (P = .003) were associated with negative axillary status at dissection. An initial tumor size \u2264 3 cm (63 patients) was associated with pCR of the primary tumor (P = .02) but not with complete histologic clearance of axillary lymph nodes. The median length of follow-up was 75 months. In the univariate analysis, age greater than 40 years (P = .003), absence of residual nodal disease (P = .01), and pCR of the tumor (P = .05) were associated with better distant disease-free survival. Five-year distant disease-free survival rates were 73.5% \u00b1 14.9% among patients with no involved nodes at the time of surgery and 48.7% \u00b1 9.2% among patients with residual nodal disease. In the multivariate Cox regression analysis, parameters associated with poor distant disease-free survival were age \u2264 40 years (P = .002), persistence of nodal involvement (P = .03), and S-phase fraction greater than 4% (P = .02). <\/jats:p><jats:p> CONCLUSION: Our results suggest that axillary status is a better prognostic factor than response of the primary tumor to primary chemotherapy. <\/jats:p>","DOI":"10.1200\/jco.2002.20.5.1304","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T08:51:36Z","timestamp":1487926296000},"page":"1304-1310","source":"Crossref","is-referenced-by-count":278,"title":["Incidence and Prognostic Significance of Complete Axillary Downstaging After Primary Chemotherapy in Breast Cancer Patients With T1 to T3 Tumors and Cytologically Proven Axillary Metastatic Lymph Nodes"],"prefix":"10.1200","volume":"20","author":[{"given":"Roman","family":"Rouzier","sequence":"first","affiliation":[{"name":"From the Departments of Surgery, Biostatistics, Oncology, and Pathology, Institut Curie, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Marc","family":"Extra","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery, Biostatistics, Oncology, and Pathology, Institut Curie, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerzy","family":"Klijanienko","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery, Biostatistics, Oncology, and Pathology, Institut Curie, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Christine","family":"Falcou","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery, Biostatistics, Oncology, and Pathology, Institut Curie, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Asselain","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery, Biostatistics, Oncology, and Pathology, Institut Curie, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Vincent-Salomon","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery, Biostatistics, Oncology, and Pathology, Institut Curie, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Vielh","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery, Biostatistics, Oncology, and Pathology, Institut Curie, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwige","family":"Bourstyn","sequence":"additional","affiliation":[{"name":"From the Departments of Surgery, Biostatistics, Oncology, and Pathology, Institut Curie, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1-104359","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19951101)76:9<1491::AID-CNCR2820760902>3.0.CO;2-8"},{"key":"R2-104359","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.2000.1461"},{"key":"R3-104359","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199810013391407"},{"key":"R4-104359","unstructured":"Fisher  B,   Wolmark  N,   Bauer  M,  et al:   The accuracy of clinical nodal staging and of limited axillary dissection as a determinant of histologic nodal status in carcinoma of the breast.  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