Retrospective study of axillary dissection in cT1N0 triple-negative or HER2-positive breast cancer receiving upfront surgery or neoadjuvant chemotherapy

It is not clear whether neoadjuvant chemotherapy (NAC) or upfront surgery minimizes axillary dissection (ALND) risk in the contemporary cT1N0 triple negative (TN) or HER2-positive (HER2+) breast cancer patient population. A retrospective study at Memorial Sloan Kettering Cancer Center (New York, NY) included consecutive cT1N0 TN/HER2+ patients receiving NAC or upfront surgery between 01/2020 and 12-2022. The study found that nodal burden was low among these patients, and that ALND was performed in less than 2% of patients who had upfront surgery. Adjuvant systemic therapy was de-escalated among many pathologically node-negative patients following surgery.