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Omitting axillary dissection in breast cancer with sentinel-node metastases.

de Boniface J, Tvedskov TF, Rydén L, Szulkin R, Reimer T, Kühn T, for the SENOMAC Trialists’ Group.

N Engl J Med 2024; 390: 1163-1175.

Some 2766 patients with breast cancer and 1-2 positive nodes on sentinel lymph node biopsy were randomly allocated to axillary dissection or no surgery. Adjuvant treatment was similar in both groups. 5-year recurrence free survival was similar: 89.7 per cent in controls and 88.7 per cent in the axillary dissection group.

Comment: Very important trial that questions the need for a procedure that has a number of significant local complications and adverse effects on quality of life, without any evidence for survival benefit.

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