Narrative review reveals that sentinel node biopsy may replace axillary dissection, indicating potential for de-escalation in treatment after neoadjuvant chemotherapy.
SLNB has become the established standard for axillary staging in early breast cancer with a clinically negative axilla, superseding ALND entirely. Progressive de-escalation of axillary surgery has been consistently supported by high-level evidence without compromising survival. Future research will determine the feasibility of further de-escalation, particularly after neoadjuvant chemotherapy.
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Mandi et al. (2026) studied this question.
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