# SenTa Registry — Safety of TAD After Neoadjuvant Therapy (German Multicenter Prospective)

**Autores:** Kuemmel S, et al. (SenTa study, German Breast Group)
**Revista:** JAMA Surgery (2023)
**PMID:** 37285140 | **PMCID:** PMC10248815
**DOI:** [10.1001/jamasurg.2023.1772](https://doi.org/10.1001/jamasurg.2023.1772)
**Fuente:** PubMed (abstract; full text vía DOI)

## Relevancia
Registro prospectivo alemán (50 centros) que evalúa seguridad oncológica de TAD vs TAD+ALND. Respaldo adicional para omitir ALND tras ypN0, particularmente con ≥3 ganglios en TAD.

## Abstract

**Question:** Is targeted axillary dissection (TAD) without axillary lymph node dissection (ALND) after neoadjuvant systemic therapy (NST) in patients with node-positive breast cancer oncologically safe?

**Findings:** In cohort study of 199 patients, TAD alone was not significantly associated with increased risk of recurrence or death (n=119) compared with TAD+ALND (n=80).

**Meaning:** Axillary staging based on TAD without ALND was associated with excellent clinical outcomes in selected patients, mainly those with good response to NST and **≥3 TAD lymph nodes**.

## Datos clave

- N=199 pacientes (cN+ pre-NAC), mediana de edad 52
- 91.5% con 1-3 LN sospechosos
- 119 TAD solo vs 80 TAD+ALND
- Follow-up 43 meses

**Resultados:**
- iDFS no ajustada a 3 años: TAD+ALND 82.4% vs TAD solo 91.2% (p=0.04)
- Tasas recurrencia axilar: 1.4% (TAD+ALND) vs 1.8% (TAD solo) (p=0.56)
- Cox multivariable ajustado:
  - TAD solo NO asoció con mayor riesgo de recurrencia (HR 0.83; 95% CI 0.34-2.05; p=0.69)
  - TAD solo NO asoció con mayor mortalidad (HR 1.07; 95% CI 0.31-3.70; p=0.91)
- Resultados similares en 152 pacientes cN0 post-NAC

## Conclusión
TAD solo en pacientes con buena respuesta clínica a NST y ≥3 ganglios TAD ofrece resultados similares a TAD+ALND.

*Datos de PubMed/PMC. Citar: doi 10.1001/jamasurg.2023.1772*
