We have read the Correspondence from Kefah Mokbel, Fady Sourial, and their colleagues with interest, thank them for their comments, and welcome the opportunity to clarify the points they raise. Among 1585 patients with residual nodal micrometastases (ypN1mi) following neoadjuvant chemotherapy, our study failed to show a short-term oncological benefit from axillary lymph node dissection (ALND), with the exception of patients with triple-negative breast cancer (284 [18%]). The rate of axillary recurrence among the 127 patients who had triple-negative breast cancer but did not undergo completion ALND was higher than it was among the 157 who did (8·7% [95% CI 4·4–15·0] vs 2·4% [0·7–6·5], p=0·018).
The Lancet Oncology published a clinical update in Oncology on 01 Apr 2026.
The item focuses on ALND after neoadjuvant chemotherapy: a call for caution – Authors' reply.
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