{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T22:12:14Z","timestamp":1793657534466,"version":"4.5.1"},"reference-count":35,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"7","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>The nodal burden of patients with residual isolated tumor cells (ITCs) in the sentinel lymph nodes (SLNs) after neoadjuvant chemotherapy (NAC) (ypN0i+) is unknown, and axillary management is not standardized. We investigated rates of additional positive lymph nodes (LNs) at axillary lymph node dissection (ALND) and oncologic outcomes in patients with ypN0i+ treated with and without ALND.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      The Oncoplastic Breast Consortium-05\/ICARO cohort study (ClinicalTrials.gov identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT06464341\">NCT06464341<\/jats:ext-link>\n                      ) retrospectively analyzed data from patients with stage I to III breast cancer with ITCs in SLNs after NAC from 62 centers in 18 countries. The primary end point was the 3-year rate of any axillary recurrence. The rate of any invasive recurrence was the secondary end point.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      In total, 583 patients were included, of whom 182 (31%) had completion ALND and 401 (69%) did not. The median age was 48 years. Most patients (74%) were clinically node-positive at diagnosis and 41% had hormone receptor\u2013positive\/human epidermal growth factor receptor 2\u2013negative tumors. The mean number of SLNs with ITCs was 1.2. Patients treated with ALND were more likely to present with cN2\/3 disease (17%\n                      <jats:italic>v<\/jats:italic>\n                      7%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), have ITCs detected on frozen section (62%\n                      <jats:italic>v<\/jats:italic>\n                      8%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), have lymphovascular invasion (38%\n                      <jats:italic>v<\/jats:italic>\n                      24%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and receive adjuvant chest wall (89%\n                      <jats:italic>v<\/jats:italic>\n                      78%,\n                      <jats:italic>P<\/jats:italic>\n                      = .024) and nodal radiation (82%\n                      <jats:italic>v<\/jats:italic>\n                      75%,\n                      <jats:italic>P<\/jats:italic>\n                      = .038). Additional positive nodes were found at ALND in 30% of patients, but only 5% had macrometastases. The 3-year rates of any axillary and any invasive recurrence were 2% (95% CI, 0.95 to 3.6) and 11% (95% CI, 8 to 14), respectively, with no statistical difference by type of axillary surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The nodal burden in patients with ypN0(i+) was low, and axillary recurrence after ALND omission was rare in patients selected for this approach. These results do not support routine ALND in all patients with ypN0(i+).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.24.01052","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T15:59:20Z","timestamp":1730995160000},"page":"810-820","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":51,"title":["Nodal Burden and Oncologic Outcomes in Patients With Residual Isolated Tumor Cells After Neoadjuvant Chemotherapy (ypN0i+): The OPBC-05\/ICARO Study"],"prefix":"10.1200","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3511-369X","authenticated-orcid":true,"given":"Giacomo","family":"Montagna","sequence":"first","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, 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