SLNB Combined With WLNB for Axillary De-escalation in Breast Cancer Patients With Abnormal Axillary Nodes

Axillary surgery in breast cancer has evolved toward individualized and less invasive approaches. However, the optimal axillary management remains controversial for patients with clinically node-negative disease but abnormal axillary lymph nodes detected by ultrasound and confirmed metastatic by biopsy. This prospective cohort study will evaluate whether SLNB combined with WLNB can accurately assess axillary tumor burden and identify patients suitable for omission of ALND. Patients will undergo SLNB and wire localized biopsy of abnormal lymph nodes according to routine clinical practice. Pathological findings will be collected and analyzed. The study will assess the proportion of patients with ≤2 positive lymph nodes, diagnostic concordance between SLNB and WLNB, and factors associated with axillary tumor burden.