2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Ta47,Randomized trials established the safety of omitting axillary lymph node dissection (ALND) among patients with clinically node-negative breast cancer and less than 3 positive sentinel lymph nodes (+SLNs) having upfront surgery and adjuvant radiation. Patients with palpable mobile level I/II axillary adenopathy (cN1) were not eligible for these studies. Presently, more than 80% of patients with HR+/HER2- cN1 disease undergo ALND either at upfront surgery or after neoadjuvant therapy, despite evidence that 50% to 60% will have only 1 or 2 positive nodes. To determine upfront sentinel lymph node biopsy (SLNB) feasibility and evaluate ALND rate among patients with HR+/HER2- cN1 breast cancer selected with axillary ultrasound (AUS). This nonrandomized clinical trial involved patients with cTx/cT1-2 cN1 HR+/HER2- breast cancer with 3 or fewer morphologically abnormal nodes on AUS at 4 centers. The trial began on April 20, 2021, and the database for this report was frozen on September 26, 2024. Patients underwent upfront lumpectomy/mastectomy and SLNB, with single/dual-tracer mapping. ALND was indicated for 3 or more positive SLNs. The primary outcome was ALND rate. Secondary outcomes were frequency of palpable nodes being radioactive/blue and locoregional recurrence. Among 78 enrolled patients, the median (IQR) age was 58 (49.0-66.5) years. Most tumors were cT1 (37 [47%]) or cT2 (40 [51%]), 56 patients (72%) had ductal histology, and 59 tumors (76%) were moderately differentiated. On AUS, 39 patients (50%) had 1 abnormal-appearing node, 33 (42%) had 2, and 6 (8%) had 3. Median (IQR) pathologic tumor size was 2.3 (1.6-3.3) cm, 50 patients (64%) had lymphovascular invasion, and 54 (69%) had extracapsular extension. SLNB was performed with dual tracer in 68 (87%), and 3 or more SLNs were retrieved in 75 (96%). The palpable diseased nodes were blue and/or radioactive in 107 of 161 instances (66.5%). Overall, 24 patients (31%) had 1 +SLN, 30 patients (38%) had 2 +SLNs, and 24 patients (31%) had 3 or more +SLNs. SLNB alone was performed in 59 patients (76%), while 19 (24%) had ALND; indicated ALND was deferred in 5 cases. Among those with 12 months or more follow-up (n = 68; median, 25 months), there have been no isolated axillary or locoregional recurrences. This study found that SLNB is feasible among patients with cN1 HR+/HER2- disease and that resection of palpable nodes is necessary to minimize false-negative rates. This approach affords the opportunity to omit ALND and minimize morbidity among patients with cN1 cancer and limited nodal burden. ClinicalTrials.gov Identifier: NCT04854005.31:T1013, Importance Randomized trials established the safety of omitting axillary lymph node dissection (ALND) among patients with clinically node-negative breast cancer and less than 3 positive sentinel lymph nodes (+SLNs) having upfront surgery and adjuvant radiation. Patients with palpable mobile level I/II axillary adenopathy (cN1) were not eligible for these studies. Presently, more than 80% of patients with HR+/HER2− cN1 disease undergo ALND either at upfront surgery or after neoadjuvant therapy, despite evidence that 50% to 60% will have only 1 or 2 positive nodes. Objective To determine upfront sentinel lymph node biopsy (SLNB) feasibility and evaluate ALND rate among patients with HR+/HER2− cN1 breast cancer selected with axillary ultrasound (AUS). Design, Setting, and Participants This nonrandomized clinical trial involved patients with cTx/cT1-2 cN1 HR+/HER2− breast cancer with 3 or fewer morphologically abnormal nodes on AUS at 4 centers. The trial began on April 20, 2021, and the database for this report was frozen on September 26, 2024. Interventions Patients underwent upfront lumpectomy/mastectomy and SLNB, with single/dual-tracer mapping. ALND was indicated for 3 or more positive SLNs. Main Outcomes and Measures The primary outcome was ALND rate. Secondary outcomes were frequency of palpable nodes being radioactive/blue and locoregional recurrence. Results Among 78 enrolled patients, the median (IQR) age was 58 (49.0-66.5) years. Most tumors were cT1 (37 [47%]) or cT2 (40 [51%]), 56 patients (72%) had ductal histology, and 59 tumors (76%) were moderately differentiated. On AUS, 39 patients (50%) had 1 abnormal-appearing node, 33 (42%) had 2, and 6 (8%) had 3. Median (IQR) pathologic tumor size was 2.3 (1.6-3.3) cm, 50 patients (64%) had lymphovascular invasion, and 54 (69%) had extracapsular extension. SLNB was performed with dual tracer in 68 (87%), and 3 or more SLNs were retrieved in 75 (96%). The palpable diseased nodes were blue and/or radioactive in 107 of 161 instances (66.5%). Overall, 24 patients (31%) had 1 +SLN, 30 patients (38%) had 2 +SLNs, and 24 patients (31%) had 3 or more +SLNs. SLNB alone was performed in 59 patients (76%), while 19 (24%) had ALND; indicated ALND was deferred in 5 cases. Among those with 12 months or more follow-up (n = 68; median, 25 months), there have been no isolated axillary or locoregional recurrences. Conclusions and Relevance This study found that SLNB is feasible among patients with cN1 HR+/HER2− disease and that resection of palpable nodes is necessary to minimize false-negative rates. This approach affords the opportunity to omit ALND and minimize morbidity among patients with cN1 cancer and limited nodal burden. Trial Registration ClinicalTrials.gov Identifier: NCT04854005 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Nonrandomized Clinical Trial: study design Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Nonrandomized Clinical Trial (study design). Clinician-written summaries and actionable practice insights. 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BCVA improved from 2.23 to 1.77 logMAR at 12 months (mean difference −0.47; 95% CI −0.97 to 0.04), though the CI crossed zero. One early serious adverse event led to a protocol amendment; 2 participants developed persistent epithelial defects.","limitations":"- Very small sample (n=9), single-arm design with no randomized control — limits ability to draw causal conclusions.\n- Fellow eye comparator is imperfect; disease severity differed at baseline (OSS 9.4 vs 8.4).\n- 12-month follow-up may be insufficient to assess durability or late safety signals.","practice_takeaway":"RAFT-OS transplant appears feasible and safe enough to proceed to larger trials in advanced ARK, with early ocular surface gains that partially persist at 1 year. Clinicians should not yet adopt this outside a trial setting — controlled studies with longer follow-up are still needed."}},{"doi":"10.1001/jamacardio.2026.1699","pmid":"42307907","title":"AAVrh.10hFXN Gene Therapy for the Cardiomyopathy of Friedreich Ataxia","journal_title":"JAMA Cardiology","journal_issn":"2380-6583","published_at":"2026-06-17T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13276668/","source_score":24,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-22T13:23:57.068Z","updated_at":"2026-06-22T13:23:57.068Z","tags":[{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"condition","value":"Cardiomyopathy","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"condition","value":"Friedreich Ataxia","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"generic","value":"AAVrh.10hFXN","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"modality","value":"AAV Gene Therapy","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"sample_size","value":"n=17","value_numeric":17},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"study_design","value":"Nonrandomized Clinical Trial","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"warning","value":"AAVrh.10hFXN is an investigational therapy without a commercial brand name at time of publication; no brand tag applied.","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"warning","value":"Full text was inaccessible (publisher page only); summary is based solely on the abstract and results excerpt provided.","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"warning","value":"One possible vector-related myocarditis event occurred at 12 months post-therapy — notably later than typical acute AAV immune reactions, which may affect post-treatment monitoring guidance.","value_numeric":null},{"paper_doi":"10.1001/jamacardio.2026.1699","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — findings are preliminary from a small, non-randomized trial; no regulatory approval is reported.","value_numeric":null}],"summaries":{"what_studied":"Safety and preliminary efficacy of intravenous AAVrh.10hFXN gene therapy in 17 adults with Friedreich ataxia (FA) cardiomyopathy, tested across 3 dose cohorts (1.8×10¹¹, 5.6×10¹¹, and 1.2×10¹² vg/kg) in 2 pooled open-label dose-escalation trials with a mean follow-up of 20 months.","key_result":"All 4 serious adverse events resolved; cardiac FXN protein levels rose dose-dependently (cohort 1: +20%, cohort 2: +81%, cohort 3: +123% at 3 months). Left ventricular mass index (LVMI) fell ≥10% in 9 of 17 patients and stabilized in the remaining 8. Serum hs troponin I dropped ≥10% in 15 of 16 evaluable patients.","limitations":"- No randomized control arm, making it impossible to separate treatment effect from natural disease course.\n- Small sample (n=17) with short and variable follow-up (mean 20 months), limiting conclusions about durability and long-term safety.\n- Efficacy endpoints (LVMI, hs troponin I) are exploratory, not pre-specified primary outcomes.","practice_takeaway":"AAVrh.10hFXN appears well tolerated and shows early signs of cardiac benefit in FA, but clinicians should note the non-randomized design and small size — this is not yet a proven therapy. One case of possible vector-related myocarditis (at 12 months, fully resolved) warrants cardiac monitoring after dosing."}},{"doi":"10.1001/jamaophthalmol.2026.1609","pmid":"42240998","title":"Smartphone-Based Proactive Self-Screening for Ocular Surface Malignancies","journal_title":"JAMA Ophthalmology","journal_issn":"2168-6165","published_at":"2026-06-04T00:00:00.000Z","url":"https://doi.org/10.1001/jamaophthalmol.2026.1609","source_score":13,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:23:45.479Z","updated_at":"2026-06-10T14:23:45.479Z","tags":[{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"brand","value":"CaptureTumor","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"condition","value":"Ocular Surface Malignancy","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"modality","value":"Artificial Intelligence Diagnostic Tool","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"sample_size","value":"n=614","value_numeric":614},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"study_design","value":"Nonrandomized Clinical Trial","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"warning","value":"Level of evidence assigned as 2 based on prospective nonrandomized design; no randomized comparator arm was included.","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"warning","value":"The paper's DOI and publication date (2026) are consistent with today's date; the trial is recent and has not yet undergone broad independent replication.","value_numeric":null},{"paper_doi":"10.1001/jamaophthalmol.2026.1609","tag_type":"warning","value":"Very low completion rate (614/256,053 ~0.24%) may reflect significant self-selection bias, which could inflate apparent screening performance.","value_numeric":null}],"summaries":{"what_studied":"A nonrandomized clinical trial (China, Dec 2022–Jun 2023) evaluated a smartphone AI app (CaptureTumor) for self-screening of ocular surface malignancies in the general public, using multimedia outreach to recruit participants who photographed suspected lesions at home.","key_result":"Among 614 participants, 20 histopathologically confirmed malignancies were found; 19 of 20 (95%) were newly diagnosed and none required enucleation. The app achieved an AUC of 0.905 (95% CI, 0.837–0.973) at the individual level and 0.977 (95% CI, 0.964–0.990) at the population level, with 89.3% sensitivity and 95.9% specificity.","limitations":"- Nonrandomized design with self-selected participants, limiting generalizability beyond a motivated screening population.\n- Conducted entirely in China; performance in other ethnic groups and healthcare settings is unknown.\n- Only 614 of 256,053 reached individuals completed screening (~0.24% uptake), raising questions about real-world scalability.","practice_takeaway":"A smartphone AI app can detect ocular surface malignancies with high accuracy using patient-captured photos, potentially enabling early diagnosis before vision-threatening progression. Clinicians should be aware of this mobile screening model as a triage tool, particularly for populations with limited access to slit-lamp examination."}},{"doi":"10.1016/j.eururo.2026.04.029","pmid":"42106276","title":"10-yr Survival and Toxicity Outcomes of Stereotactic Body Radiotherapy for Prostate Cancer: A Nonrandomized Clinical Trial","journal_title":"European Urology","journal_issn":"0302-2838","published_at":"2026-05-08T00:00:00.000Z","url":"https://doi.org/10.1016/j.eururo.2026.04.029","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-16T13:22:28.025Z","updated_at":"2026-05-16T13:22:28.025Z","tags":[{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"modality","value":"Stereotactic Body Radiotherapy","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"sample_size","value":"n=310","value_numeric":310},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"study_design","value":"Nonrandomized Clinical Trial","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"warning","value":"Median follow-up was 9 years despite the paper reporting '10-year' outcomes — some estimates may be based on fewer patients reaching that landmark.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"warning","value":"Only a single SBRT delivery platform (noncoplanar robotic CyberKnife-type) was used; results may not fully apply to linac-based SBRT programs.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.029","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the rarity of 10-year multi-institutional SBRT data; the nonrandomized design means causal comparisons with other modalities should be made cautiously.","value_numeric":null}],"summaries":{"what_studied":"This multi-institutional, nonrandomized trial (21 centers, n=310) evaluated 10-year survival and toxicity outcomes of SBRT (40 Gy in 5 fractions, robotic platform with real-time motion tracking) in low-risk (n=172) and intermediate-risk (n=138) organ-confined prostate cancer patients treated 2008–2010, without adjuvant hormone therapy.","key_result":"At 10 years, overall survival was 84% and relapse-free survival (RFS) was 90% (94% low-risk, 86% intermediate-risk; favorable vs. unfavorable intermediate: 92% vs. 77%). Cumulative grade 3 GI or GU toxicity was just 1.4–1.5%; grade 2+ GU toxicity was 14%; no grade 4–5 events occurred.","limitations":"- Nonrandomized design limits comparison to other modalities (e.g., conventional fractionation or brachytherapy).\n- Median follow-up was 9 years, so true 10-year estimates are extrapolated for some patients.\n- Single SBRT platform (noncoplanar robotic) may not generalize to linac-based SBRT delivery.","practice_takeaway":"Prostate SBRT (40 Gy/5 fx) offers durable disease control with very low severe toxicity at 10 years, supporting its use as a long-term standard option for low- and intermediate-risk prostate cancer. Clinicians can reassure patients that grade 3+ GI/GU events remain rare (<2%) even at a decade of follow-up."}},{"doi":"10.1001/jamasurg.2026.1268","pmid":"42090164","title":"Sentinel Lymph Node Biopsy for Patients With cN1 HR+/HER2− Breast Cancer and Palpable Adenopathy","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-05-06T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13150728/","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-11","doi":"10.1001/jamasurg.2026.1268","days":"7","issn":"2168-6254","rank":"5","field":"Clinical Medicine","score":"10","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1001/jamasurg.2026.1268","title":"Sentinel Lymph Node Biopsy for Patients With cN1 HR+/HER2- Breast Cancer and Palpable Adenopathy: A Nonrandomized Clinical Trial.","journal":"JAMA surgery","methods":"","results":"Among 78 enrolled patients, the median (IQR) age was 58 (49.0-66.5) years. Most tumors were cT1 (37 [47%]) or cT2 (40 [51%]), 56 patients (72%) had ductal histology, and 59 tumors (76%) were moderately differentiated. On AUS, 39 patients (50%) had 1 abnormal-appearing node, 33 (42%) had 2, and 6 (8%) had 3. Median (IQR) pathologic tumor size was 2.3 (1.6-3.3) cm, 50 patients (64%) had lymphovascular invasion, and 54 (69%) had extracapsular extension. SLNB was performed with dual tracer in 68 (87%), and 3 or more SLNs were retrieved in 75 (96%). The palpable diseased nodes were blue and/or radioactive in 107 of 161 instances (66.5%). Overall, 24 patients (31%) had 1 +SLN, 30 patients (38%) had 2 +SLNs, and 24 patients (31%) had 3 or more +SLNs. SLNB alone was performed in 59 patients (76%), while 19 (24%) had ALND; indicated ALND was deferred in 5 cases. Among those with 12 months or more follow-up (n = 68; median, 25 months), there have been no isolated axillary or locoregional recurrences.","abstract":"$30","keywords":[],"pubmed_id":"42090164","conclusions":"","publication_date":"2026-05-06T00:00:00"},"crossref":{"DOI":"10.1001/jamasurg.2026.1268","URL":"https://doi.org/10.1001/jamasurg.2026.1268","ISSN":["2168-6254"],"link":[{"URL":"https://jamanetwork.com/journals/jamasurgery/articlepdf/2848645/jamasurgery_mamtani_2026_oi_260022_1777474148.97529.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Sentinel Lymph Node Biopsy for Patients With cN1 HR+/HER2− Breast Cancer and Palpable Adenopathy"],"author":[{"given":"Anita","family":"Mamtani","sequence":"first","affiliation":[{"name":"Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}]},{"given":"Melissa","family":"Pilewskie","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor"}]},{"given":"Niamey","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hartford HealthCare, Hartford, Connecticut"}]},{"given":"Heiwon","family":"Chung Whang","sequence":"additional","affiliation":[{"name":"Lehigh Valley Topper Cancer Institute, Lehigh Valley Health Network, Lehigh Valley, Pennsylvania"}]},{"given":"Andrea V.","family":"Barrio","sequence":"additional","affiliation":[{"name":"Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}]},{"given":"Leah","family":"Bassin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hartford HealthCare, Hartford, Connecticut"}]},{"given":"Deborah","family":"Capko","sequence":"additional","affiliation":[{"name":"Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}]},{"given":"Daniel X.","family":"Choi","sequence":"additional","affiliation":[{"name":"Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}]},{"given":"Hiram S.","family":"Cody","sequence":"additional","affiliation":[{"name":"Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}]},{"given":"Stephanie","family":"Downs-Canner","sequence":"additional","affiliation":[{"name":"Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}]},{"given":"Mahmoud","family":"El-Tamer","sequence":"additional","affiliation":[{"name":"Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}]},{"given":"Mary L.","family":"Gemignani","sequence":"additional","affiliation":[{"name":"Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"},{"name":"Department of 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paper.","value_numeric":null}],"summaries":{"what_studied":"This nonrandomized clinical trial evaluated the feasibility of upfront sentinel lymph node biopsy (SLNB) and the rate of axillary lymph node dissection (ALND) avoidance in 78 patients with cTx/cT1-2 cN1 HR+/HER2− breast cancer who had ≤3 morphologically abnormal nodes on axillary ultrasound (AUS), across 4 centers (April 2021–September 2024).","key_result":"SLNB alone was achieved in 76% of patients (59/78), avoiding ALND; only 24% (19/78) required ALND (≥3 positive SLNs). 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Palpable diseased nodes were captured by tracer (blue/radioactive) in only 66.5% of instances (107/161), underscoring the need to manually resect palpable nodes.","limitations":"- Short median follow-up (25 months) is insufficient to assess long-term locoregional control.\n- Small sample size (n=78) at 4 centers limits generalizability.\n- Nonrandomized design with no comparator arm; 5 patients deferred indicated ALND, complicating outcome interpretation.","practice_takeaway":"For patients with cN1 HR+/HER2− breast cancer and ≤3 abnormal nodes on AUS, upfront SLNB can spare 3 in 4 patients from ALND — but surgeons must manually excise palpable nodes, as tracers alone miss them about one-third of the time."}}],"initialOffset":5,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"study_design","value":"Nonrandomized Clinical Trial"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Study Designs","href":"/hub/tag/study_design"},{"name":"Nonrandomized Clinical Trial"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"study_design","hub_tag_value":"Nonrandomized Clinical Trial"}}}]]

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