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SABCS 2022 | Nodal recurrence following axillary downstaging with neoadjuvant chemotherpay + omission of ALND

Walter P. Weber, MD, University Hospital Basel, Basel, Switzerland, provides an overview of the OPBC-04/EUBREAST-06/OMA study on oncological outcomes following omission of axillary lymph node dissection in node-positive patients downstaging to node negative with neoadjuvant chemotherapy. The study was designed to explore the optimal staging procedure for patients with clinically node-positive breast cancer that turns into clinically node-negative following neoadjuvant systemic therapy. There is no consensus on which axillary staging procedure should be used in this setting, sentinel lymph node biopsy alone or in combination with localization and retrieval of the clipped positive node, also known as targeted axillary dissection. Data were collected from 19 centers in the Oncoplastic Breast Consortium (OPBC) and EUBREAST networks. The event rate of axillary recurrence was exceedingly low in both arms, there was no benefit for the more extensive procedure targeted axillary dissection. A difference was observed with significantly fewer nodes removed with targeted axillary dissection; however, this was a small difference of only one node. This interview took place at the San Antonio Breast Cancer Symposium (SABCS) 2022 in San Antonio, TX.

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