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In 278 patients with a positive family history of breast cancer followed for a median 96 months, local recurrence, regional recurrence, and CBC risk were comparable to general population rates by SIR analysis, with recurrence risk driven more by biological subtype than family history.

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.