Kefah Mokbel, Chair of Breast Cancer Surgery at London Breast Institute, shared on LinkedIn:
“Why this matters: Mastectomy patients have been underrepresented in prior trials (IBCSG 23-01, AATRM) because they don’t get the “free” axillary control that whole-breast radiotherapy provides.
This is real-world, guideline-implementation data – not a trial population – with 13-year follow-up in the ALND arm.
The caveat worth flagging: radiotherapy data were missing for most mastectomy patients, and cause of death wasn’t captured – so residual confounding, particularly age-related, can’t be excluded. The AR increase after omission is real and shouldn’t be dismissed, even if it hasn’t yet translated into a survival signal.
Bottom line: this reinforces that SLNB alone is appropriate for carefully selected patients with minimal nodal burden – including after mastectomy – but AR surveillance still matters.”
Title: Axillary Recurrence and Survival After Omission of Axillary Lymph Node Dissection in Patients with Breast Cancer and Micrometastases or Isolated Tumor Cells in the Sentinel Node: A Danish National Register Study
Authors: Riazan Heidari Rosenlund Korsholm, Niels Kroman, Tove F. Tvedskov, Frederikke Munc
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