Sarah Sammons: How do we tailor adjuvant therapy without axillary dissection?

Sarah Sammons, Medical Oncologist at Dana-Farber’s Breast Oncology Center, recently shared a post by Massimo Cristofanilli, Director of Breast Medical Oncology at the Weill Cornell Medicine, adding:

“Hot tumor board topic! How do we tailor adjuvant therapy without axillary dissection?

Of patients with 2+ SLNs, 51.3% had more nodes on dissection.

In 2485 patients nodal status =

• N1: 99.5% SLN group vs. 87% axillary dissection,
• N2: 0.5% SLN group vs. 10% axillary dissection,
• N3: 3.0% axillary dissection.

12-13% of patients will have N2-3 disease in which we may want to escalate therapy. Calculators can help us guess nodal status to estimate who may be at the highest risk.

All we can do is use the information at hand and estimation of additional nodes to make decisions.”

Quoting Massimo Cristofanilli’s post:

“Omitting Axillary Dissection in Breast Cancer with Sentinel-Node Metastases at the New England Journal of Medicine.
Continued de-escalation of local therapies in breast cancer.”

Sources: Sarah Sammons/X and Massimo Cristofanilli/X