Simons JM, Maaskant-Braat AJG, Luiten EJT, et al. - Via performing a survey amongst members of the European Society of Surgical Oncology and two UK-based Associations (the Association of Breast Surgery and the British Association of Surgical Oncology), researchers investigated breast cancer specialists regarding current practices for axillary staging after neoadjuvant systemic therapy (NST) for breast cancer patients with a clinically positive axillary node (cN+). Analyzing the collected responses, they identified a wide variation in current axillary staging and management practices in cN + patients after NST. Routine use of ALND was reported by 57.3% respondents and use of less invasive restaging of the axilla with possible omission of ALND was reported by 42.7% respondents, after NST. In the latter group, the use of nodal response seen on imaging for guiding the axillary restaging procedure was reported by 85%. Regarding respondents that do use imaging: 95% would perform a less invasive staging procedure in case of complete nodal response on imaging (63% sentinel lymph node biopsy (SLNB), excision of a previously marked positive node with SLNB (21%) and without SLNB (11%)). Seventy-seven percent reported performing ALND in the case of no nodal response on imaging.