Axillary Dissection Unnecessary in Breast Cancer Patients with Positive Sentinel Lymph Nodes

Long-term results confirm that survival is noninferior with sentinel versus axillary dissection.

Initial results from the landmark ACOSOG Z0011 trial of breast cancer patients with positive sentinel lymph nodes showed that — despite the potential for residual axillary disease after sentinel lymph node dissection (SLND) alone — omission of axillary lymph node dissection (ALND) did not affect survival at a median follow-up of 6.3 years (NEJM JW Oncol Hematol Mar 2011 and JAMA 2011; 305:569).

Given that most patients in the study had estrogen receptor–positive tumors, which are associated with later potential disease recurrence, the investigators have now analyzed 10-year survival data from ACOSOG Z0011 on 891 women with metastases detected at SLND who then underwent either ALND or no axillary treatment. Eligible women had invasive breast …

Reviewing Author

Henry Mark Kuerer, MD, PhD, FACS

Disclosures

Speaker's BureauPhysicians’ Education Resource, LLC

RoyaltiesMcGraw-Hill Professional; UpToDate, Inc.

Editorial BoardsAnnals of Surgical Oncology

Leadership Positions in Professional SocietiesAmerican Society of Breast Surgeons (Chair, Publications Committee)