[Articles] Lymph node surgery and CDK4/6 inhibitors in early breast cancer: a pooled analysis from five randomised trials

A pooled analysis of five randomised trials, published in The Lancet Oncology, evaluated whether performing sentinel lymph node biopsy (SLNB) or complete axillary lymph node dissection (cALND) solely to determine eligibility for CDK4/6 inhibitor therapy is justified in early breast cancer. The researchers found that the number needed to diagnose and treat was very high, the procedures added substantial surgical morbidity and cost, and the resulting overall survival benefit was only marginal. These findings challenge the rationale for routine lymph node surgery when its primary purpose is to guide CDK4/6 inhibitor use, supporting a trend toward surgical de-escalation in early-stage disease. The study is expected to influence clinical decision-making and may prompt updates to treatment guidelines regarding axillary management in this setting.