In the Z0011 trial criteria, which patient with a positive sentinel node biopsy may safely avoid axillary lymph node dissection?
- A Patient undergoing mastectomy with 1-2 positive sentinel nodes
- B Patient undergoing breast conservation with 1-2 positive sentinel nodes and planned whole breast radiotherapy ✓
- C Patient with 3 positive sentinel nodes undergoing breast conservation
- D Patient receiving neoadjuvant chemotherapy with residual nodal disease
Correct answer: B. Patient undergoing breast conservation with 1-2 positive sentinel nodes and planned whole breast radiotherapy
Explanation
The ACOSOG Z0011 trial demonstrated that in patients with cT1-2 tumors undergoing breast-conserving surgery with 1-2 positive sentinel lymph nodes who receive whole-breast tangential field radiotherapy, axillary lymph node dissection (ALND) can be safely omitted without compromising regional control or survival. The trial excluded patients undergoing mastectomy, those with 3 or more positive nodes, and those who received neoadjuvant chemotherapy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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