Key points are not available for this paper at this time.
The German Guideline Committee (AGO: Working Group on Gynecologic Cancers) updated its yearly recommendations on the diagnosis and treatment of breast cancer in March 2026. Chapters on oncological and oncoplastic-reconstructive surgery are coordinated with the Working Group for Plastic, Aesthetic, and Reconstructive Surgery in Gynecology (AWOgyn). The most important changes include the ommission of sentinel lymph node biopsy (SLNB) and preffered axillary staging in patients with node-positive breast cancer undergoing neoadjuvant chemotherapy (NACT). Targeted axillary dissection (TAD) is endorsed as the method of choice AGO ++ in patients converting from cN + to ycN0 status, and other de-escalated techniques (SLNB, target lymph node biopsy TLNB) are also possible options AGO +. Following NACT, ALND is indicated only when macrometastatic disease is detected in the sentinel and/or in the target lymph node.
Banys-Paluchowski et al. (Wed,) studied this question.