Axillary radiotherapy instead of axillary dissection: A randomized trial

Stefano Zurrida, Roberto Orecchia, Viviana Galimberti, Alberto Luini, Irene Giannetti, Bettina Ballardini, Andrea Amadori, Giulia Veronesi, Umberto Veronesi

Research output: Contribution to journalArticle

Abstract

Background: Surgical dissection of the axilla is a standard part of the treatment of breast cancer but, by itself, does not improve prognosis; furthermore, most patients with small-sized breast cancer and a clinically uninvolved axilla never develop axillary metastases. We evaluated disease-free and overall survival in patients with early breast cancer treated by breast-conservation surgery without dissection of axillary lymph nodes, receiving or not receiving axillary radiotherapy (RT). Methods: From 1995 to 1998, 435 patients older than 45 years with breast cancer up to 1.2 cm were randomized, 214 to breast conservation without axillary treatment and 221 to breast conservation plus axillary RT. Results: After a follow-up of 28 to 68 months (median, 42 months), two women (1%) in the no axillary treatment group and one (.5%) in the axillary RT group developed axillary metastases. Rates of distant metastases and local treatment failure were also very low, and 5-year overall survival was 99%. Conclusions: After a mean of 46 months of follow-up, our results indicate that axillary dissection can be safely avoided in patients with very small invasive carcinomas and a clinically negative axilla. Whether axillary RT should be added can be assessed only by longer follow-up.

Original languageEnglish
Pages (from-to)156-160
Number of pages5
JournalAnnals of Surgical Oncology
Volume9
Issue number2
DOIs
Publication statusPublished - 2002

Keywords

  • Axillary radiotherapy
  • Breast cancer
  • Lymph nodes
  • Metastases
  • Randomized trial

ASJC Scopus subject areas

  • Surgery
  • Oncology

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