Conclusions
tumor
TUMOR
Results of this cohort study suggest that omission of ALND was associated with understaging in patients with cN-positive BC with a high tumor burden in the axilla. However, missing knowledge of the exact number of positive nodes did not have a relevant impact on adjuvant and postneoadjuvant systemic treatment decisions. Therefore, although ALND may be considered in individual patients being treated by a multidisciplinary team, results of the present study suggest that nodal burden as determined by TAS without ALND does not generally result in underuse of systemic therapy.