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Omitting completion axillary lymph node dissection in breast cancer patients with sentinel lymph node micrometastases undergoing mastectomy : results from the prospective SENOMIC trial

Andersson, Yvette ; Bergkvist, Leif ; Rydén, Lisa LU orcid ; Celebioglu, Fuat ; Falck, Anna Karin LU ; Norenstedt, Sophie ; Ruderfors Malterling, Rebecka ; Vikhe Patil, Eva ; Frisell, Jan and De Boniface, Jana (2025) In British Journal of Surgery 112(6).
Abstract

Background Breast cancer patients undergoing mastectomy are not well represented in studies evaluating the omission of completion axillary lymph node dissection (cALND) due to sentinel lymph node (SLN) metastases. Methods The prospective multicentre SENOMIC cohort trial included patients with breast cancer and SLN micrometastases between October 2013 and December 2022. Completion ALND was omitted and nodal radiotherapy discouraged. Patients undergoing mastectomy were selected for the present analysis. The primary endpoint was event-free survival. Secondary endpoints were the isolated axillary recurrence rate (ARR) and cancer-specific and overall survival. Results In the SENOMIC trial, 455 of 882 included patients underwent mastectomy,... (More)

Background Breast cancer patients undergoing mastectomy are not well represented in studies evaluating the omission of completion axillary lymph node dissection (cALND) due to sentinel lymph node (SLN) metastases. Methods The prospective multicentre SENOMIC cohort trial included patients with breast cancer and SLN micrometastases between October 2013 and December 2022. Completion ALND was omitted and nodal radiotherapy discouraged. Patients undergoing mastectomy were selected for the present analysis. The primary endpoint was event-free survival. Secondary endpoints were the isolated axillary recurrence rate (ARR) and cancer-specific and overall survival. Results In the SENOMIC trial, 455 of 882 included patients underwent mastectomy, 407 of whom did not receive nodal radiotherapy. The median follow-up time was 53 (range 5-109) months. The estimated 5-year event-free, cancer-specific, and overall survival were 86.8%, 97.0% and 91.6%, respectively. Isolated axillary recurrence was found in 14 patients (3.1%). Conclusion Event-free survival after omission of cALND in breast cancer patients with SLN micrometastases undergoing mastectomy was excellent, despite a higher ARR than previously reported. Long-term follow-up is important to validate the safety of this approach, but omission of cALND should be regarded as routine care.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Surgery
volume
112
issue
6
article number
znaf111
publisher
Oxford University Press
external identifiers
  • scopus:105008233744
  • pmid:40476677
ISSN
0007-1323
DOI
10.1093/bjs/znaf111
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved.
id
66a4126a-1317-401f-976f-05597ff251f5
date added to LUP
2025-12-22 12:22:34
date last changed
2025-12-23 03:08:12
@article{66a4126a-1317-401f-976f-05597ff251f5,
  abstract     = {{<p>Background Breast cancer patients undergoing mastectomy are not well represented in studies evaluating the omission of completion axillary lymph node dissection (cALND) due to sentinel lymph node (SLN) metastases. Methods The prospective multicentre SENOMIC cohort trial included patients with breast cancer and SLN micrometastases between October 2013 and December 2022. Completion ALND was omitted and nodal radiotherapy discouraged. Patients undergoing mastectomy were selected for the present analysis. The primary endpoint was event-free survival. Secondary endpoints were the isolated axillary recurrence rate (ARR) and cancer-specific and overall survival. Results In the SENOMIC trial, 455 of 882 included patients underwent mastectomy, 407 of whom did not receive nodal radiotherapy. The median follow-up time was 53 (range 5-109) months. The estimated 5-year event-free, cancer-specific, and overall survival were 86.8%, 97.0% and 91.6%, respectively. Isolated axillary recurrence was found in 14 patients (3.1%). Conclusion Event-free survival after omission of cALND in breast cancer patients with SLN micrometastases undergoing mastectomy was excellent, despite a higher ARR than previously reported. Long-term follow-up is important to validate the safety of this approach, but omission of cALND should be regarded as routine care.</p>}},
  author       = {{Andersson, Yvette and Bergkvist, Leif and Rydén, Lisa and Celebioglu, Fuat and Falck, Anna Karin and Norenstedt, Sophie and Ruderfors Malterling, Rebecka and Vikhe Patil, Eva and Frisell, Jan and De Boniface, Jana}},
  issn         = {{0007-1323}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  publisher    = {{Oxford University Press}},
  series       = {{British Journal of Surgery}},
  title        = {{Omitting completion axillary lymph node dissection in breast cancer patients with sentinel lymph node micrometastases undergoing mastectomy : results from the prospective SENOMIC trial}},
  url          = {{http://dx.doi.org/10.1093/bjs/znaf111}},
  doi          = {{10.1093/bjs/znaf111}},
  volume       = {{112}},
  year         = {{2025}},
}