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Updated: Sep 1, 2026
Single-port Non-liposuction Endoscopic Axillary Lymph Node Dissection in Breast Cancer Surgery
Published on: April 3, 2026
A Multicenter Retrospective Study on Screening Patients Eligible for Exemption From Axillary Surgery Based on the
Xingye Sheng1, Hong Yin2, Xiaoqing Zhang3
1Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Introduction:
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.
Patients And Methods:
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.
Results:
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.
Conclusions:
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.
