FROM SABCS 2023
Axillary lymph node dissection might be unneeded if breast cancer clients with one or 2 favorable guard lymph nodes strategy to have adjuvant nodal radiation, according to a significant Scandinavian trial provided at the San Antonio Breast Cancer Symposium.
“It implies that you wear’t requirement to dissect the axilla if you” are going to “radiate the axilla.” “For the UnitedStates, that’s the conclusion since there are still focuses that do both, and that’s out,” lead privateinvestigator Jana de Boniface, MD, PhD, a breast cancer cosmeticsurgeon at the Karolinska Institutet, Stockholm, stated in an interview.
The researchstudy included to a consistent style at this year’s conference, securing breast cancer clients from doing too much and triggering unneeded damage. Some even questioned if 5 years of endocrine treatment is needed.
Dr Boniface shared her ideas after providing the Scandinavian trial, SENOMAC, which she led.
SENOMAC randomized 1204 clients with one or 2 favorable guard lymph nodes to axillary dissection; 1335 with the verysame finding were randomized to no dissection.
Subjects had scientifically T1-3 N0 main breast cancer. About 89% in both arms went on to adjuvant radiation, consistingof nodal radiation, and practically all likewise went on to systemic treatment, which consistedof endocrine treatment in over 90%. Only about 2% of topics had neoadjuvant treatment.
At a typical follow-up of almost 4 years, recurrence-free survival was practically similar in both groups, with 8% of clients in the dissection arm and 7.1% in the no-dissection group having reoccurrences. Estimated 5-year recurrence-free survival was simply shy of 90% in both groups. Skipping dissection was highly non-inferior to having one (P < .001).
SENOMAC “clearly reveals that you puton’t requirement to dissect the axilla if you have one to 2 favorable guard lymph nodes” so long as clients have adjuvant nodal radiation. Recurrence-free survival “curves almost overlap, and we cannot