Is axillary dissection necessary for adjuvant treatment decisions in node-positive breast cancer?
triple-negative, response-driven
RESIDUAL DISEASE
De-escalation of axillary surgery, especially in node-positive patients challenges established criteria for adjuvant therapy (i.e., chemotherapy in patients with ≥4 positive LN in luminal BC), as well as recently investigated patient subgroups with LN-based cut-off values for the decision on both systemic as well as local therapies, and even response-driven therapeutic decisions after NST. A recent review addressed the impact of the monarchE and RxPONDER trials on axillary surgery [Moreover, response-driven therapy in patients with residual disease has been shown to enhance oncologic outcomes, both in HER2 positive and triple-negative BC [A planned substudy of the TAXIS trial investigates the influence of known nodal burden after ALND compared to TAS on systemic treatment decisions.