A 48-year-old woman with ER+/PR+/HER2- invasive ductal carcinoma (T2N1M0) undergoes breast-conserving surgery and sentinel lymph node biopsy revealing 2/3 sentinel nodes positive. Axillary node dissection is being considered. Which trial demonstrated non-inferiority of sentinel lymph node biopsy alone (without completion axillary dissection) in patients receiving whole-breast radiotherapy?
- A ACOSOG Z0011 trial ✓
- B AMAROS trial
- C ALMANAC trial
- D NSABP B-32 trial
Correct answer: A. ACOSOG Z0011 trial
Explanation
The ACOSOG Z0011 trial demonstrated that in patients with T1–T2 breast cancer, 1–2 positive sentinel lymph nodes, and planned whole-breast radiotherapy, omitting completion axillary lymph node dissection did not compromise locoregional control or overall survival. AMAROS compared axillary radiotherapy versus dissection for positive sentinel nodes. ALMANAC validated sentinel node biopsy itself. NSABP B-32 validated sentinel node biopsy as equivalent to axillary dissection for node-negative patients.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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