ArticleBreast (Edinburgh, Scotland)2026
Optimizing axillary lymph node management in early-stage HR+/HER2- breast cancer: Practical strategies for enhanced detection rates.
Article in Breast (Edinburgh, Scotland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Standardizing imaging-confirmed nodal assessment in early breast cancer: the case for c,iN0.Breast (Edinburgh, Scotland) · 2026Article
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13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionAbemaciclib is a globally approved, standard-of-care adjuvant treatment for HR+/HER2-high-risk EBC which significantly improved outcomes in combination with ET, versus ET alone, in the pivotal monarchE trial. Nodal involvement is a major adverse prognostic factor in EBC; however, clarity around methods and timepoints for evaluation of involved ALNs and identification of high-risk patients eligible for adjuvant therapy is currently lacking.
methodsA medical advisory board met virtually in November 2023 to discuss the changing landscape of axillary management in early breast cancer. The discussion assessed the knowledge gap caused by locoregional de-escalation for patients with HR+/HER- EBC leading to challenges in the appropriate identification of eligible patients for adjuvant CDK4/6 inhibitors. The panel aligned on recommendations to address these gaps and summarized these with the intent to raise awareness.
resultsPositive lymph node status can be denoted by pathological or clinical confirmation of breast cancer in ALNs. The panel therefore agreed that pragmatic strategies for ALN evaluation may include less invasive approaches such as ultrasound and clinical assessment. Evaluation of ALNs should be performed expeditiously post-diagnosis and before neoadjuvant treatment. A diagnostic algorithm has been developed to guide clinicians.
conclusionOptimized staging and risk assessment in HR+/HER2- EBC is critical to identify high-risk patients eligible for CDK4/6 inhibitors. Implementing these recommendations may improve patient outcomes in the adjuvant setting.
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