In the Z0011 trial, which subset of patients with a positive sentinel lymph node was shown NOT to require axillary lymph node dissection when undergoing breast-conserving surgery with whole-breast radiation?
- A Patients with extracapsular nodal extension in sentinel nodes
- B Patients with ≥3 positive sentinel nodes
- C Patients undergoing mastectomy with 1-2 positive sentinel nodes
- D Patients with 1-2 positive sentinel nodes undergoing breast-conserving surgery with whole-breast radiation and adjuvant systemic therapy ✓
Explanation
The ACOSOG Z0011 trial demonstrated that in clinically node-negative patients undergoing breast-conserving surgery with whole-breast radiation and adjuvant systemic therapy who had 1-2 positive sentinel lymph nodes, completion axillary dissection did not improve locoregional recurrence, disease-free survival, or overall survival compared to sentinel node biopsy alone. Exclusions from this trial included patients with extracapsular extension, ≥3 positive nodes, those undergoing mastectomy, and those receiving accelerated partial breast irradiation. Z0011 fundamentally changed axillary management in early breast cancer.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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