Regarding the ACOSOG Z0011 trial in early breast cancer, which conclusion is MOST clinically significant?
- A Sentinel lymph node biopsy is inferior to axillary lymph node dissection
- B Axillary irradiation must be given if more than one sentinel node is positive
- C Patients with 1-2 positive sentinel nodes undergoing breast conservation can omit axillary dissection ✓
- D Completion axillary dissection improves overall survival in node-positive patients
Correct answer: C. Patients with 1-2 positive sentinel nodes undergoing breast conservation can omit axillary dissection
Explanation
The ACOSOG Z0011 trial showed that in patients with T1-T2 invasive breast cancer undergoing breast-conserving surgery with 1-2 positive sentinel lymph nodes who receive whole breast irradiation and systemic therapy, completion axillary lymph node dissection does not improve locoregional control or overall survival. This landmark trial changed practice significantly by sparing many patients from the morbidity of full axillary dissection.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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