Radiotherapy vs. Surgery for Breast Cancer Patients with Axillary Lymph Node Metastases

The AMAROS trial shows that radiation resulted in excellent local control with less early lymphedema than axillary lymph node dissection.

Axillary lymph node dissection (ALND) provides excellent local control for patients with sentinel lymph node (SLN)-positive breast cancer, but it is associated with harmful effects. To determine if radiotherapy would be as effective as ALND with fewer adverse effects, European investigators conducted a phase III, multicenter, randomized, open-label, noninferiority trial (AMAROS), involving 1425 women with invasive breast cancer (0.5–5 cm) and a positive axillary SLN. Of these patients, about 60% had macrometastases, and 40% had micrometastases or isolated tumor cells.

Patients received ALND or axillary radiation to all three anatomical levels and the supraclavicular nodes. Of patients randomized to ALND, 77% had no additional positive nodes …

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)