👉Data from the ACOSOG Z0011 trial suggests completion axillary dissection can be avoided for small cancers with clinically node-negative, sentinel node (SN)-positive disease, provided that systemic therapy and whole-breast irradiation (WBI) are incorporated into the treatment strategy for early-stage breast cancer following breast-conserving surgery (BCS).
👉This trial took clinically node-negative patients with 1 to 2 positive SNs by hematoxylin and eosin staining who were treated with BCS and whole-breast irradiation and assigned them into 1 of 2 arms:
👉One that received completion ALND versus the other that received only SLNB.
👉The 10-year overall survival in the SLNB only group versus the completion ALND group was 86.3% and 83.6%, respectively.
👉Similarly, disease-free survival was 80.2% and 78.2%, respectively.
👉The study demonstrated that the 10-year in-breast recurrence rate was higher in the ALND group, 5.6% versus 3.8% (P=0.13) than in the sentinel lymph node resection only group.
👉Regional recurrence occurred in less than 1.5% of patients in both arms.
- Giuliano AE, McCall L, Beitsch P, et al. Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg. 2010;252:426-432.
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