Bridging Global Disparities in Breast Cancer Care: External Validation Study of the MD Anderson "Nomogram To Predict Positive Sentinel Lymph Nodes After Neoadjuvant Chemotherapy" and Its Financial Implications of Axillary De-escalation in a Resource Limited Setting.

A further analysis was done to see if the sentinel lymph node negative rate was related to the response seen in the tumor post chemotherapy showed a trend that robust response in tumor had fewer positive nodes however it was not significant statistically ( Table 3 ).

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However, since the 1990s there has been an increasing trend of axillary de-escalation as imaging and sentinel lymph node biopsies show fair sensitivity and specificity of predicting a clinically negative axilla. 1 The Z011 trial was one of the first few trials that showed axillary surgery could be safely replaced with a sentinel lymph node biopsy alone.

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