According to a new study published in the journal The Lancet Oncology, dissection and radiotherapy of the axillary lymph node following a positive sentinel node are effective approaches for proving axillary control in patients with T1-2 primary breast cancer without palpable lymphadenopathy.
For the randomized, multicenter, open-label, phase 3 non-inferiority AMAROS study, researchers randomly assigned 4,806 patients to receive axillary lymph node dissection, the current standard of care, or axillary radiotherapy. Patients with positive sentinel lymph nodes were followed for a median of 6.1 years.
Of the 744 patients with a positive sentinel node in the axillary lymph node dissection group, four patients experienced axillary recurrence compared with seven of 681 patients with a positive sentinel node in the axillary radiotherapy group. Results showed a 5-year axillary recurrence rate of 0.43% (95% CI, 0.00 - 0.92) in the dissection group compared with 1.19% (95% CI, 0.31-2.08) in the radiotherapy group.
Axillary lymph node dissection was more often associated with lymphoedema in the ipsilateral arm versus axillary radiotherapy after 1, 3, and 5 years. The findings suggest that axillary radiotherapy provides equivalent regional control with fewer adverse effects versus axillary lymph node dissection.
The authors aimed to assess whether axillary radiotherapy provides comparable regional control with fewer side–effects. Axillary lymph node dissection and axillary radiotherapy after a positive sentinel node provide excellent and comparable axillary control for patients with T1—2 primary breast cancer and no palpable lymphadenopathy. Axillary radiotherapy results in significantly less morbidity.