Clinical breast cancer最新文献

{"title":"The Immunomodulatory Effect of Various Anesthetic Factors and Techniques on Patients Undergoing Breast Cancer Surgery: A Systematic Review and Meta-analyses of RCTs.","authors":"Paraskevas Mavropoulos, Georgios Konstantis, Georgia Tsaousi, Sofia Baka, Varvara Ziaka, Vasilis-Spyridon Tseriotis, Zoi Tsimtsiou, Chryssa Pourzitaki","doi":"10.1016/j.clbc.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.clbc.2026.09.002","url":null,"abstract":"<p><p>Breast cancer is the most common type of cancer among women, while several factors seem to play a role in carcinogenesis. Recent findings suggest that some anesthetic factors and techniques contribute to immune suppression and metastasis, while others have beneficial effects. The aim of this meta-analysis is to identify the overall effects of different anesthetic modalities on the patients' immune system after breast cancer surgery. A systematic search was conducted from February 2026 to March 2026 in PubMed, CENTRAL, and Scopus. Only Randomized controlled trials were included. As primary endpoints were considered CD4+ T cell, CD8+ T cell, and Natural killer (NK) cell counts at 24, 48, and 72 hours after the end of the surgery. As secondary endpoints were considered, Leucocytes, Lymphocytes, Neutrophils, the Neutrophil- to- Lymphocyte ratio (NLR), CD4+/CD8+, IL-2, IL-6, Matrix metalloproteinase-9 at the same time points. Sixteen studies met the inclusion criteria. We concluded in positive effects of the combination of general anesthesia (GA) and regional anesthesia on CD4+ T cells (Standardized mean difference (SMD) 0.35 [0.06; 0.64], I² 38.7%), NK cells (SMD 0.40 [0.05; 0.75], I² 56%), and NLR (SMD -0.42 [-0.64; -0.19], I² 0%) 24 hours after surgery. Also, the comparison between total intravenous anesthesia and inhalational anesthesia revealed a statistically significantly higher total leukocyte count in the inhalational anesthesia group (SMD 0.61 [0.19; 1.03], I² 0%). Combined regional and GA exerts a beneficial effect regarding NK cell counts, CD4+ T cell counts, and NLR (PROSPERO: CRD42024564788).</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-excision in Ductal Carcinoma In Situ: Comment on Dorten et al., \"Re-excision in Ductal Carcinoma In Situ Is Not Associated With Improved Local Control\".","authors":"Zeina Ayoub, Lara Hilal, Malek Safa","doi":"10.1016/j.clbc.2026.09.005","DOIUrl":"https://doi.org/10.1016/j.clbc.2026.09.005","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Small Incision: The Value of Endoscopic and Robotic Mastectomy.","authors":"Gianluca Vanni, Marco Pellicciaro, Marco Materazzo, Marco Bernini, Oreste Claudio Buonomo","doi":"10.1016/j.clbc.2026.09.004","DOIUrl":"https://doi.org/10.1016/j.clbc.2026.09.004","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overall Survival After Sentinel Lymph Node Biopsy Versus Axillary Lymph Node Dissection in Patients With Three Recorded Positive Nodes: A National Cancer Database Analysis","authors":"Kai Huang,&nbsp;Emmanuel Gabriel","doi":"10.1016/j.clbc.2026.07.033","DOIUrl":"10.1016/j.clbc.2026.07.033","url":null,"abstract":"<div><h3>Background</h3><div>Randomized trials support omission of completion axillary lymph node dissection (ALND) in selected patients with 1 or 2 positive sentinel lymph nodes, but evidence for 3 positive sentinel nodes is limited. We evaluated the association between the extent of axillary surgery and overall survival (OS) in patients with 3 recorded positive nodes.</div></div><div><h3>Patients and Methods</h3><div>Female patients with cT1–2N0M0 unilateral invasive breast cancer who underwent breast-conserving surgery between 2012 and 2016 and had 3 positive lymph nodes were identified in the National Cancer Database. The sentinel lymph node biopsy (SLNB) group had 3 positive sentinel nodes without completion ALND; the ALND group had 3 total positive nodes after completion dissection. The primary outcome was OS.</div></div><div><h3>Results</h3><div>Among 700 patients, 217 (31%) underwent SLNB alone and 483 (69%) underwent completion ALND. Thirty-six deaths occurred. Irradiation to breast/chest-wall lymph-node regions was recorded in 59.4% and 57.6%, respectively (<em>P</em> = .56), although specific nodal basins were unavailable. At a median follow-up of 51.6 months, 5-year OS was similar between the SLNB and ALND groups (94.3% vs. 93.8%, <em>P</em> = .85). Omission of ALND was not significantly associated with OS after adjustment (adjusted HR 0.94, 95% CI 0.44-2.01, <em>P</em> = .85). Hormone receptor-negative disease and omission of adjuvant therapy were independently associated with worse survival.</div></div><div><h3>Conclusion</h3><div>Omission of ALND was not associated with inferior OS in patients with 3 positive lymph nodes. These findings support prospective evaluation and should not be interpreted as evidence that all additional axillary treatment can be omitted.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 9","pages":"Pages 186-192"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Targeted Axillary Dissection in Clinically Node-Positive Breast Cancer: Adoption Trends and Comparative Outcomes at a Single Institution","authors":"Skylar Harbour,&nbsp;Michelle Ki,&nbsp;Connie Chen,&nbsp;Victoria Dai,&nbsp;Sheldon Feldman,&nbsp;Ethan Ravetch,&nbsp;Ruth Samson,&nbsp;Maureen McEvoy","doi":"10.1016/j.clbc.2026.07.032","DOIUrl":"10.1016/j.clbc.2026.07.032","url":null,"abstract":"<div><h3>Background</h3><div>Historically, axillary lymph node dissection (ALND) was the standard of care for patients with node-positive breast cancer following neoadjuvant systemic therapy (NST). Current evidence supports de-escalated axillary procedures, including targeted axillary dissection (TAD) after NST, which demonstrate low false-negative rates and reduced morbidity compared with ALND. This study analyzed the temporal trends in the adoption of TAD among clinically node-positive breast cancer patients at a single institution.</div></div><div><h3>Patients and Methods</h3><div>Our retrospective cohort study included patients diagnosed with clinical N1 (cN1) breast cancer who underwent axillary lymph node excision at the Breast Care Center at Montefiore Einstein between 2017 and 2024. Annual evaluations assessed temporal trends in the planning and completion of TAD compared to ALND. Multivariate analyses were performed to identify clinically relevant factors associated with the utilization of TAD.</div></div><div><h3>Results</h3><div>The study cohort included 224 patients, of whom 116 (51%) received TAD, 14 (6%) received SNLB, and 94 (43%) received ALND. Compared to TAD, patients who received ALND had a greater average number of nodes removed (4.5 vs. 15.3, <em>P</em> &lt; .001). Pathologic outcomes favored TAD, with significantly higher rates of pathologic complete response (pCR) (47.7% vs. 8.5%, <em>P</em> &lt; .001) and axillary complete response (66.2% vs. 13.8%, <em>P</em> &lt; .001). Temporal trend analysis indicated a significant increase in TAD planning from 2017 to 2024 (<em>P</em> &lt; .001), with 37.2% higher odds of planned TAD each year. In contrast, the actual completion of TAD rose more modestly<u>,</u> with a 13.7% increase (<em>P</em> = .032).</div></div><div><h3>Conclusion</h3><div>TAD is increasingly selected as the planned surgical approach, particularly for patients who have a higher response to NST. High conversion rates to ALND reflect ongoing preoperative challenges, with limited frozen analysis causing overtreatment in ALND patients with pCR and undertreatment in TAD patients needing delayed ALND. These findings highlight the evolving practice patterns toward axillary conservation and the crucial role of intraoperative evaluation of residual nodal disease in optimizing surgical management.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 9","pages":"Pages 137-144"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of Biennial Breast Screening in Women With Dense Breasts: Exploratory Analysis of Pathways Incorporating an Emerging Blood RNA Test","authors":"Jacie T. Cooper,&nbsp;Alan Hollingsworth,&nbsp;Randy D. Moore,&nbsp;Cheryl Croft,&nbsp;John Schneider,&nbsp;Kristina D. Rinker,&nbsp;Eldon Spackman","doi":"10.1016/j.clbc.2026.07.029","DOIUrl":"10.1016/j.clbc.2026.07.029","url":null,"abstract":"<div><h3>Background</h3><div>Emerging blood-based tests have potential to complement current breast imaging to increase early-stage detection for women with dense breasts. This analysis examines the cost-effectiveness of potential pathways using preliminary data from an emerging blood test to inform future research.</div></div><div><h3>Materials and Methods</h3><div>Preliminary accuracy results for the blood test were modeled in combination, and in comparison, with mammography for biennial screening starting at age 40 for women with dense breasts using a lifetime Markov model. Costs, life years (LYs) and quality-adjusted life-years (QALYs) of each screening pathway were compared. The primary results were probabilistic incremental cost-effectiveness ratios (ICER).</div></div><div><h3>Results</h3><div>Modeling showed the blood test generating 22.40 LYs, 18.78 QALYs per individual, and lifetime costs of $21,642. Combination of blood test and mammography produced higher LYs, QALYs, and costs comparatively (22.42 LYs, 18.80 QALYs, $24,986), resulting in an ICER of $169,384 per QALY compared to blood test alone. Two-way sensitivity analysis showed positive net monetary value for a range of blood test sensitivities and specificities.</div></div><div><h3>Conclusions</h3><div>The blood test may represent a cost-effective option relative to mammography alone or in combination for biennial screening of women with dense breasts, supporting the rationale for continued evidence generation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 9","pages":"Pages 171-178"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Endocrine Therapies: Current Status and Future Directions","authors":"Elena Brierley-Green,&nbsp;Niharika Duggirala,&nbsp;Kelly E McCann,&nbsp;Rena Callahan,&nbsp;Aditya Bardia,&nbsp;Marla Lipsyc-Sharf","doi":"10.1016/j.clbc.2026.07.010","DOIUrl":"10.1016/j.clbc.2026.07.010","url":null,"abstract":"<div><div>Recent advances in endocrine therapy have led to the development of novel oral agents that target estrogen receptor signaling in estrogen receptor-positive, HER2-negative (ER+/HER2-) breast cancer. This review outlines key findings from clinical trials of Food and Drug Administration (FDA)-approved selective estrogen receptor degraders (SERDS), including elacestrant and imlunestrant, the newly FDA-approved proteolysis-targeting chimera (PROTAC) vepdegestrant, as well as emerging oral SERDs, PROTACs, complete estrogen receptor antagonists, selective estrogen receptor covalent antagonists (SERCAs), and other targeted therapies. We explore their mechanisms, efficacy, tolerability, and potential to improve treatment options and outcomes in both metastatic and early-stage disease.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 9","pages":"Pages 127-136"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CDK4/6i in the Underrepresented Histological Subtypes of HR±/HER2- Metastatic Breast Cancer: A Real-World Cohort Study of Effectiveness and Safety","authors":"Claudia von Arx,&nbsp;Alessandra Calabrese,&nbsp;Michela Piezzo,&nbsp;Vincenzo Di Lauro,&nbsp;Claudia Martinelli,&nbsp;Claudia Calderaio,&nbsp;Margherita Tafuro,&nbsp;Annarita Verrazzo,&nbsp;Raffaella Di Monda,&nbsp;Enrico Magri,&nbsp;Maria Luisa D’aulisio Garigliota,&nbsp;Anna Maria Di Filippo,&nbsp;Roberto Buonaiuto,&nbsp;Giuseppe Buono,&nbsp;Roberta Caputo,&nbsp;Daniela Cianniello,&nbsp;Ivana Cerillo,&nbsp;Stefania Cocco,&nbsp;Rossana Di Rienzo,&nbsp;Francesco Nuzzo,&nbsp;Michelino De Laurentiis","doi":"10.1016/j.clbc.2026.07.035","DOIUrl":"10.1016/j.clbc.2026.07.035","url":null,"abstract":"<div><h3>Background</h3><div>Metastatic (m) HR-positive/HER2-negative special-type breast cancer (STBC) exhibits distinct biological behaviors compared with no special-type BC (NSTBC), yet their management is largely extrapolated from trials dominated by NSTBC. To improve understanding of real-world (rw) clinical outcomes, this study evaluated the effectiveness of CDK4/6 inhibitors (i) specifically in patients with mSTBC, providing clinical relevant insights into their therapeutic impact.</div></div><div><h3>Patients and Methods</h3><div>This retrospective cohort study included patients with mSTBC treated with first- or second-line CDK4/6i plus endocrine therapy (ET). Real-world progression-free survival (rwPFS) and overall survival (rwOS) were estimated using the Kaplan–Meier method, and differences between subgroups were evaluated using log-rank tests.</div></div><div><h3>Results</h3><div>From April 2016 to December 2024, 181 patients received CDK4/6i-based therapy. Median rwPFS was 18.2 months (95% CI, 16-22.1) and median rwOS was 58.1 months (95% CI, 49.4-77.4). A statistically significant difference in rwOS was observed between patients treated with aromatase inhibitors + CDK4/6i versus fulvestrant + CDK4/6i (77.4 vs. 42.4 months; unadjusted HR = 2.2; <em>P</em> = .002). No other subgroup analyses demonstrated statistically significant differences. Common adverse events included neutropenia, anemia, and diarrhea; 32% of patients required dose reductions, which did not adversely affect survival outcomes. Following CDK4/6i progression, overall rwPFS2 was 29.7 months (95% CI, 25.9-32.2). Chemotherapy was the most frequently used post-CDK4/6i treatment, while ET combined with an mTOR-inhibitor provided the longest rwPFS2.</div></div><div><h3>Conclusion</h3><div>CDK4/6i represent a safe and effective therapeutic option for mSTBC. Nevertheless, dedicated studies and tailored treatment strategies are warranted to optimize post-CDK4/6i treatment in these subgroups.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 9","pages":"Pages 145-153"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Expanded Access to Germline High Penetrance Genetic Testing for Women With a New Diagnosis of Invasive Breast Cancer or High-Grade DCIS","authors":"Sarah P. Hudson-Phillips,&nbsp;Akriti Nanda,&nbsp;Mohamed Attia,&nbsp;Wadha Al Yaqout,&nbsp;Evelyn Marshall,&nbsp;Jennifer E. Rusby,&nbsp;Katherine Krupa,&nbsp;Peter A. Barry,&nbsp;Marios Konstantinos Tasoulis,&nbsp;Gerald Gui,&nbsp;Radhika Merh,&nbsp;Bethany Torr,&nbsp;Zoe Kemp,&nbsp;Angela George,&nbsp;Clare Turnbull,&nbsp;Rachel L. O’Connell","doi":"10.1016/j.clbc.2026.07.031","DOIUrl":"10.1016/j.clbc.2026.07.031","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 3% of patients with breast cancer have an inherited pathogenic variant in high-penetrance genes such as <em>BRCA1, BRCA2</em> or <em>PALB2</em>. Knowledge of genetic testing result may impact surgery undertaken at the time of index breast cancer treatment. The aim of this study was to evaluate the impact of a positive high penetrance genetic test (HPGT) on surgical decision-making.</div></div><div><h3>Methods</h3><div>Females &gt;18 years diagnosed with invasive breast cancer or high-grade Ductal carcinoma in situ (DCIS) without prior BRCA-gene testing were included. In patients with a germline pathogenic variant (GPV) further data on surgical decision-making were collected.</div></div><div><h3>Results</h3><div>Five hundred seventy-six patients were included. Median time from consent to result was 33 days (inter-quartile range 25-45). GPV rate was 3.6% (21/576): 11 <em>BRCA1</em> (1.9%), 6 <em>BRCA2</em> (1%), 4 <em>PALB2</em> (0.7%). Five (23.8%) of 21 patients with GPV would not have been eligible for HPGT on the UK National Health Service R208 pathway.</div><div>Four hundred eighty (83.3%) of the 576 patients underwent primary breast cancer surgery; 121 (25.2%) of 480 patients received results pre-operatively, 359 (74.8%) post-operatively. Pre-operative GPV knowledge significantly influenced the initial surgical procedure undertaken (<em>P</em> = .002). Uptake of subsequent risk-reducing surgery was higher with a preoperative result (100% vs. 71.4%), although this difference was not statistically significant (<em>P</em> = .24).</div></div><div><h3>Conclusions</h3><div>Early timing of positive HPGT results significantly influences surgical decision-making and increases pre-operative uptake of bilateral risk-reducing mastectomy. Expanded HPGT access in this study identified 24% additional patients with GPV who would not have met current UK testing criteria.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 9","pages":"Pages 179-185"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multicenter Retrospective Study on Screening Patients Eligible for Exemption From Axillary Surgery Based on the Pathological Remission of the Breast After Neoadjuvant Therapy","authors":"Xingye Sheng,&nbsp;Hong Yin,&nbsp;Xiaoqing Zhang,&nbsp;Lingjun Ma,&nbsp;Xinyu Wan,&nbsp;Wenxiang Shi,&nbsp;Mingyu Wang,&nbsp;Junhan Li,&nbsp;Danni Shen,&nbsp;Ying Zhu,&nbsp;Weifeng Qian,&nbsp;Jue Wang","doi":"10.1016/j.clbc.2026.08.002","DOIUrl":"10.1016/j.clbc.2026.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>With better responses to neoadjuvant therapy (NST), clinicians are increasingly inclined to spare axillary surgery. Yet it is not well defined whether tumor regression in the breast can serve as a reliable surrogate for nodal clearance across diverse nodal burdens at baseline and intrinsic tumor biology.</div></div><div><h3>Patients and Methods</h3><div>We retrospectively analyzed 864 patients treated with NST across 5 Chinese institutions. Subgroup analyses were performed according to initial nodal stage (cN0, cN1, cN2/3), molecular subtype, breast pathological response (ypT0, ypTis, or non-pCR), and final preoperative imaging. The endpoint was ypN status.</div></div><div><h3>Results</h3><div>Breast pCR was observed in 34.4%. Among cN0 patients with breast pCR, 95.6% achieved axillary pCR, reaching 100% in TNBC or HER2-positive tumors, irrespective of ypT0 or ypTis. In cN1 disease, breast pCR correlated with a 93.0% axillary pCR; notably, all ypT0 cases in TNBC/HER2-positive were node-negative. For cN2/3 patients with breast pCR, the false-negative rate of imaging in predicting nodal clearance remained below 5% for both ypT0 and ypTis.</div></div><div><h3>Conclusions</h3><div>Selected patients may be candidates for axillary surgery omission—specifically, TNBC/HER2-positive cN0 patients with breast pCR (ypT0/is), and cN1 patients who achieve ypT0 (but not ypTis). For cN2/3 patients with breast pCR and negative post-treatment imaging, foregoing SLNB appears worth considering, though prospective data are needed to confirm safety.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 9","pages":"Pages 204-210"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}