Multicenter prospective trial of safety of targeted axillary dissection after neoadjuvant therapy for node-positive breast cancer

The increasing use of neoadjuvant systemic therapy (NST) has led to substantial pathological complete response rates in patients with initially node-positive, early breast cancer, thereby questioning the need for axillary lymph node dissection (ALND). The multicenter prospective SenTa study in Germany assessed oncological safety of targeted axillary dissection (TAD) alone after NST in 199 patients. TAD alone was not significantly associated was an increased risk of recurrence or death in 119 patients compared with 80 patients who underwent TAD with ALND. The authors conclude that axillary staging based on TAD without ALND was associated with excellent clinical outcomes in selected patients, mainly those with good response to NST en at least 3 TAD lymph nodes.