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Omission of Surgical Axillary Staging in Clinically Node-Negative T1-T2 Breast Cancer: INSEMA Trial Findings
Dec 13, 2024, 18:20

Omission of Surgical Axillary Staging in Clinically Node-Negative T1-T2 Breast Cancer: INSEMA Trial Findings

The results of the INSEMA trial were recently presented at SABCS24.

Axillary Staging

The INSEMA trial evaluated whether omitting surgical axillary staging in patients with clinically node-negative, T1-T2 invasive breast cancer could achieve noninferior outcomes compared to sentinel lymph node biopsy after a median follow-up of 6 years.

Axillary Surgery in Breast Cancer — Primary Results of the INSEMA Trial

Authors: Toralf Reimer, Angrit Stachs, Kristina Veselinovic, Thorsten Kühn, Jörg Heil, Silke Polata, Frederik Marmé, Thomas Müller, Guido Hildebrandt, David Krug, Beyhan Ataseven, Roland Reitsamer, Sylvia Ruth, Carsten Denkert, Inga Bekes, Dirk-Michael Zahm, Marc Thill, Michael Golatta, Johannes Holtschmidt, Michael Knauer, Valentina Nekljudova, Sibylle Loibl, Bernd Gerber.

Axillary Staging

Healthcare professionals shared their insights about the trial on social media:

Tatiana Prowell:

“INSEMA Trial:

Omission of sentinel node biopsy (SLNB) in patients with clin node-neg early breast cancer did not result in inferior IDFS (at 6 yrs: 91.7 vs 91.9%). Suggests no SLNB may be for age 50+ with gr 1-2, ER+/HER2- tumors, up to 2 cm.”

Omission of Surgical Axillary Staging in Clinically Node-Negative T1-T2 Breast Cancer: INSEMA Trial Findings

Stephanie Graff:

“Dr. Singh draws nice comparisons between SOUND and INSEMA.”

Omission of Surgical Axillary Staging in Clinically Node-Negative T1-T2 Breast Cancer: INSEMA Trial Findings

Armando Orlandi:

“Cowabunga! Riding Breast Cancer’s Biggest Data’s Wave from SABCS24.

INSEMA: Skip SLNB safely in early BC! Non-inferior outcomes in low-risk patients (HR+/HER2-, G1-2, ≤5cm) with BCT. 5yr iDFS: 91.9% vs 91.7%, minimal axillary events.”

Omission of Surgical Axillary Staging in Clinically Node-Negative T1-T2 Breast Cancer: INSEMA Trial Findings

Rachel Rabinovitch:

“SABCS24-INSEMA Trial. Rand +/- SLNBx for cT1-2N0 all ax U/S, lump/RT to breast only. N=5502. No difference in invDFS or OS. Very low LRF. Together with SOUND trial, appropriate to omit SLNBx for cT1N0 HR+ age >50.”

Omission of Surgical Axillary Staging in Clinically Node-Negative T1-T2 Breast Cancer: INSEMA Trial Findings

Alizée Camps:

“General Session 2 at SABC24.

No axillary surgery versus axillary sentinel lymph node biopsy in patients with early invasive breast cancer and breast-conserving surgery: Final primary results of the Intergroup-Sentinel-Mamma (INSEMA) trial.”

Omission of Surgical Axillary Staging in Clinically Node-Negative T1-T2 Breast Cancer: INSEMA Trial Findings