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In 21 patients with metaplastic breast cancer receiving neoadjuvant chemotherapy, 48% achieved pCR—higher than prior estimates—with all pCR patients alive and disease-free at follow-up, suggesting modern regimens including pembrolizumab may improve outcomes in this chemoresistant subtype.

In this institutional retrospective review, 14.4% of clinically node-negative patients meeting SOUND trial criteria had nodal metastases on SLNB, underscoring the need for careful multidisciplinary decision-making before integrating axillary staging de-escalation into practice.

In 167 patients with HR+/HER2− breast cancer after neoadjuvant chemotherapy, lymphovascular invasion, number of positive sentinel nodes, and >50% positive sentinel nodes were the strongest predictors of high axillary burden; a nomogram was developed to guide axillary management decisions.

A decision tree cost-utility analysis found ICG more cost-effective than methylene blue for SLNB in breast cancer (ICER $4,044/QALY), with Monte Carlo simulation showing an 80% probability of ICG superiority.