ASO Author Reflections: Nodal Recurrence Is Rare in Patients with cN+/ycN0 Breast Cancer after Neoadjuvant Chemotherapy Regardless of the Extent of Axillary Surgery or Nodal Pathology in the NEOSENTITURK-Trials MF18-02/18-03 Provided Regional Nodal Irradiation Is Administered.

The combined analysis of the retrospective multicentre and prospective multicenter cohort registry trial NEOSENTITURK MF18-02/18-03 (NCT04250129) investigated the outcomes and factors associated with recurrence in patients with cT1-4N1-3M0 who underwent a succesful sentinel lymph node biopsy or targeted axillary dissection (n = 1470), with or without axillary lymph node dissection (n = 937) after neoadjuvant chemotherapy. The present large registry data suggest that axillary recurrences (AR) can be detected at exceedingly low rates (< 0.5%) within 3 years after surgery. This is regardless of the extent of axillary surgery or nodal pathology, provided that regional nodal irradiation is administered. Factors associated with increased risk for AR included age under 45 years, nonpathologic complete response (non-pCR) in the breast, and nonluminal pathology. Similarly, having cT3-4, a non-pCR in the breast or axilla, and nonluminal pathology were identified as poor prognostic factors.