Piotr Wysocki: New data solidify the idea of omitting axillary dissection in breast cancer patients with clinically N0 disease and macrometastases in 1-2 sentinel LN
Piotr Wysocki, Head of the Clinical Oncology Department at Jagiellonian University Hospital, shared on LinkedIn:
“The results of the SENOMAC trial have been just published (April 03, 2024) in the New England Journal of Medicine. The study enrolled 2766 patients with clinically node-negative T1-T3 breast cancer with macrometastases present in 1-2 sentinel lymph nodes. The patients were randomized (1:1) to axillary lymph node dissection (ALND) followed by adjuvant treatment (systemic and radiation therapy according to current guidelines) or to adjuvant treatment only (SLNB group). Radiation therapy, including nodal target volumes, was administered to 89.9% and 88.4% of patients in the SLNB and ALND arms, respectively.
After a median follow-up of 46.8 months, the results were as follows for SLNB and ALND groups, respectively:
the estimated 5-year overall survival – 92.9% and 92.0%,
the estimated 5-year breast cancer–specific survival – 97.1% and 96.6%,
the estimated 5-year recurrence-free survival was 89.7 and 88.7%.
The hazard ratio for recurrence or death in the SLNB group, as compared with the ALND group, was 0.89 (95% CI, 0.66 to 1.19), which was significantly (P<0.001) below the noninferiority margin.
The results of the SENOMAC trial, which are in line with those of the ACOSOG Z0011 and AMAROS trials, provide robust proof that axillary lymph node dissection can be safely omitted in breast cancer patients with clinically negative lymph nodes and 1-2 positive sentinel lymph nodes.”
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Source: Piotr Wysocki/LinkedIn
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