De-escalating the axilla: oncologic and morbidity outcomes of targeted axillary dissection versus axillary lymph node dissection following neoadjuvant systemic therapy in clinically node-positive breast cancer within a single institution.

In cN1 patients treated with neoadjuvant systemic therapy, targeted axillary dissection was associated with significantly lower rates of lymphedema and upper extremity morbidity compared to axillary lymph node dissection, while also demonstrating higher pathologic and axillary complete response rates.

These key findings emphasize the benefit of selective axillary de-escalation with targeted axillary dissection, supporting its role in reducing treatment-related morbidity while maintaining oncologic safety.