[Comment] Micrometastatic axillary disease after neoadjuvant treatment

In The Lancet Oncology, Giacomo Montagna and colleagues1 report the results of the large international retrospective OPBC-07/microNAC study, comparing the oncological outcomes and 3-year axillary recurrence rate for 1585 patients with breast cancer and residual micrometastases at axillary staging after neoadjuvant chemotherapy with and without completion axillary lymph node dissection (ALND). The feasibility and safety of axillary surgery de-escalation in patients with breast cancer who are at high risk of arm morbidity after ALND is an important clinical question.