Limitations
tumor
TUMOR
This was a prospective observational cohort study embedded in a randomized clinical trial. Accordingly, although the 2 groups with or without ALND were well balanced for patient, tumor, and treatment characteristics as well as other known prognostic variables, residual confounding by unknown factors cannot be excluded. In addition, the present study was primarily designed to investigate the association of ALND use with proportion and type of systemic therapy; other aspects including, eg, density of dosing, were not addressed. Dose-dense adjuvant chemotherapy has been shown to improve DFS compared with standard interval chemotherapy in patients with node-positive early BC.