Axillary Radiotherapy as an Alternative to Axillary Lymph Node Dissection for Early Breast Cancer
Posted: Friday, February 1, 2019
Emile J.T. Rutgers, MD, PhD, of the Netherlands Cancer Institute, Amsterdam, and colleagues suggest that axillary radiotherapy may provide a safe and effective alternative to axillary lymph node dissection for patients who have breast cancer with a tumor-positive sentinel node biopsy. In fact, comparable 10-year recurrence and survival rates were reported with both approaches, based on the randomized, phase III AMAROS clinical trial. These results were presented at the 2018 San Antonio Breast Cancer Symposium (SABCS; Abstract GS4-01).
“Moving forward, we need to better tailor treatment for each individual patient. Some will still need axillary treatment, and our data indicate that axillary radiotherapy is a good option here,” clarified Dr. Rutgers, in a SABCS press release.
A total of 1,425 patients had a positive sentinel lymph node biopsy; 744 of them were randomly assigned to receive axillary lymph node dissection and 681, axillary radiotherapy. The 10-year data displayed survival rates of 81.4% with axillary radiotherapy and 84.6% with axillary lymph node dissection; metastasis-free survival rates were 78.2% and 81.7%, respectively. As for recurrence, 1.82% of patients exposed to axillary radiotherapy experienced recurrence, compared with 0.93% of patients assigned to axillary lymph node dissection.
Patients treated with axillary radiotherapy experienced a significantly greater proportion of second primary cancer than those treated with axillary lymph node dissection (11.0% vs. 7.7%). The researchers clarified that this difference was mainly due to a higher incidence of contralateral breast cancer in this group, with no conclusive evidence that the second primary cancers were induced by radiotherapy.
Disclosure: Study authors’ disclosures can be found at SABCS.org.