{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:32:54Z","timestamp":1787614374577,"version":"build-2736575974"},"reference-count":28,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This study aimed to identify clinicopathological factors associated with axillary pathological complete response (ApCR) in patients with HER2-positive breast cancer presenting with clinically node-positive disease (cN+) confirmed by biopsy who received neoadjuvant therapy (NAT), and to assess the prognostic significance of ApCR on survival outcomes. Materials and Methods: A total of 221 patients with clinically node-positive (cN+) HER2-positive invasive breast cancer, with nodal involvement confirmed by fine-needle aspiration or core needle biopsy, who received neoadjuvant therapy (NAT) and subsequently underwent surgery at three centers between January 2015 and January 2025 were retrospectively reviewed. The association between clinicopathological factors and axillary pathological complete response (ApCR) was analyzed using logistic regression. Survival analyses were performed using the Kaplan\u2013Meier method. Results: The median follow-up duration was 34.3 months. Axillary pathological complete response (ApCR) was achieved in 67.9% of patients. The ApCR rate was higher in stage II disease compared with stage III (76.9% vs. 62.9%). Patients with HER2 3+ tumors demonstrated a higher ApCR rate (70.8%) than those with HER2 2+\/FISH+ tumors (46.2%). In multivariable logistic regression, HER2 3+ status (OR = 2.745; 95% CI: 1.138\u20136.619; p = 0.025) and lower clinical stage (OR = 2.251; 95% CI: 1.182\u20134.287; p = 0.014) were independently associated with a higher likelihood of achieving ApCR. In survival analyses, the 3-year event-free survival rate was 92% (95% CI: 86\u201398%) in the ApCR group, compared with 75% (95% CI: 63\u201387%) in the non-ApCR group. Kaplan\u2013Meier analysis demonstrated that ApCR was a significant prognostic factor for EFS (p = 0.001). Median overall survival (OS) was not reached in either group due to the limited number of death events. Conclusions: ApCR was frequent in node-positive HER2-positive breast cancer after neoadjuvant therapy. HER2 3+ status and lower clinical stage independently predicted ApCR, which in turn was associated with improved event-free survival. These findings underscore the prognostic relevance of ApCR in this setting.<\/jats:p>","DOI":"10.3390\/medicina62010200","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:23:56Z","timestamp":1768811036000},"page":"200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinicopathological Predictors of Axillary Pathological Complete Response and Its Prognostic Significance in Clinically Node-Positive (cN+), HER2-Positive Breast Cancer Following Neoadjuvant Therapy"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5797-0804","authenticated-orcid":false,"given":"\u015eahin","family":"Bedir","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Istinye University Faculty of Medicine, Gaziosmanpa\u015fa Hospital, Istanbul 34250, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8375-1575","authenticated-orcid":false,"given":"U\u011fur Alp","family":"Ye\u015filova","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-300X","authenticated-orcid":false,"given":"Merve","family":"Toko\u00e7in","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul 34100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0734-0692","authenticated-orcid":false,"given":"Bur\u00e7in","family":"\u00c7akan Demirel","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul 34214, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yakup","family":"Bozkaya","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Istinye University Faculty of Medicine, Gaziosmanpa\u015fa Hospital, Istanbul 34250, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdilkerim","family":"Oyman","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Istinye University Faculty of Medicine, Gaziosmanpa\u015fa Hospital, Istanbul 34250, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murad","family":"Guliyev","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1227-9996","authenticated-orcid":false,"given":"Hamza","family":"Abbasov","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nebi Serkan","family":"Demirci","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezgi","family":"De\u011ferli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Bak\u0131rkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul 34147, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2264-8417","authenticated-orcid":false,"given":"Gamze","family":"Usul","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-4540","authenticated-orcid":false,"given":"Ebru","family":"\u015een","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2406-1946","authenticated-orcid":false,"given":"Nil\u00fcfer","family":"Bulut","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3375-9465","authenticated-orcid":false,"given":"G\u00f6kmen Umut","family":"Erdem","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E495","DOI":"10.1016\/j.clbc.2019.05.009","article-title":"Adjuvant treatment of triple-negative metaplastic breast cancer with weekly paclitaxel and platinum chemotherapy: Retrospective case review from a single institution","volume":"19","author":"Harper","year":"2019","journal-title":"Clin. 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