cT1–2N0 Breast Cancer: Less- and More-Invasive Treatment Results
By: Bruce Cleary
Posted: Monday, November 20, 2017
In a major long-term follow-up study, sentinel lymph node dissection (SLND) and breast-conserving therapy was no less effective than the more invasive axillary lymph node dissection (ALND) in certain breast cancer patients with sentinel lymph node metastases, according to 10-year overall survival data. These women had T1 or T2 invasive primary breast cancer, no palpable axillary adenopathy, and one or two metastatic sentinel lymph nodes.
Armando E. Giuliano, MD, of Cedars-Sinai Medical Center, Los Angeles, and colleagues published their findings from the American College of Surgeons Oncology Group (ACOSOG) Z0011 (Alliance) trial in JAMA. “These findings do not support routine use of axillary lymph node dissection in this patient population based on 10-year outcomes,” they concluded.
Nearly 900 women took part in this study, with half receiving SLND alone and the other half receiving ALND. At 10 years, patients treated with SLND alone had an overall survival of 86.3% versus 83.6% for those treated with ALND. In addition, the 10-year disease-free survival of 80.2% in the SLND group was not inferior to that in the ALND group (78.2%). There did not appear to be a significant difference in 10-year regional recurrence between the two groups as well.