In the ACOSOG Z0011 trial, women with T1-2 breast cancers and 1-2 positive sentinel nodes who underwent breast-conserving surgery and whole breast radiation were randomized to axillary lymph node dissection versus no dissection. Which finding was most significant?
- A ALND improved overall survival significantly
- B No significant difference in locoregional recurrence or overall survival between arms ✓
- C Axillary recurrence was >15% in the no-ALND arm
- D ALND reduced systemic recurrence by 30%
Correct answer: B. No significant difference in locoregional recurrence or overall survival between arms
Explanation
The ACOSOG Z0011 trial showed no significant difference in locoregional recurrence (1.8% vs 3.7%) or overall survival between complete ALND and no further axillary surgery in patients with 1-2 positive sentinel nodes undergoing breast-conserving surgery with whole-breast radiation and systemic therapy. This changed practice by sparing selected patients the morbidity of ALND. The trial fundamentally altered the need for routine ALND for limited sentinel node disease.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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