Trial reportAnnals of surgery2016
Locoregional Recurrence After Sentinel Lymph Node Dissection With or Without Axillary Dissection in Patients With Sentinel Lymph Node Metastases: Long-term Follow-up From the American College of Surgeons Oncology Group (Alliance) ACOSOG Z0011 Randomized Trial.
Trial report in Annals of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03939598 (Feasibility of Preoperative Tattooing of Percutaneously Biopsied Axillary Lymph Node), which is not on this map. Cited by 206 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Feasibility of Preoperative Tattooing of Percutaneously Biopsied Axillary Lymph Node: A Quasi Experimental Pilot Study
Who cites it
206 citing papers in PubMed, 7 syntheses or guidelines pooled it, 492 citations in OpenAlex.
- Uncertainties and controversies in axillary management of patients with breast cancer.Cancer treatment reviews · 2023Pooled it
- Axillary management in patients with clinical node-negative early breast cancer and positive sentinel lymph node: a systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Comparing Early-Stage Breast Cancer Patients with Sentinel Lymph Node Metastasis with and without Completion Axillary Lymph Node Dissection: A Systematic Review and Meta-Analysis.Asian Pacific journal of cancer prevention : APJCP · 2022Pooled it
- Prognostic significance of occult lymph node metastases in breast cancer: a meta-analysis.BMC cancer · 2021Pooled it
- Axillary Management in Women with Early Breast Cancer and Limited Sentinel Node Metastasis: A Systematic Review and Metaanalysis of Real-World Evidence in the Post-ACOSOG Z0011 Era.Annals of surgical oncology · 2021Pooled it
- Comparing Observation, Axillary Radiotherapy, and Completion Axillary Lymph Node Dissection for Management of Axilla in Breast Cancer in Patients with Positive Sentinel Nodes: A Systematic Review.Annals of surgical oncology · 2020Pooled it
- Meta-analysis of tumour burden in pre-operative axillary ultrasound positive and negative breast cancer patients.Breast cancer research and treatment · 2017Pooled it
- Use of indocyanine green fluorescence versus patent blue V dye for sentinel lymph node biopsy in early breast cancer, a randomized controlled trial.Journal of the Egyptian National Cancer Institute · 2026Trial
- Predictive nomogram based on serum tumor markers and clinicopathological features for stratifying lymph node metastasis in breast cancer.BMC cancer · 2022Trial
- A negative binomial regression model for risk estimation of 0-2 axillary lymph node metastases in breast cancer patients.Scientific reports · 2020Trial
- Positive nonsentinel lymph nodes are associated with poor survival in breast cancer: results from a retrospective study.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2019Trial
- Trial
- Partial-breast radiotherapy after breast conservation surgery for patients with early breast cancer (UK IMPORT LOW trial): 5-year results from a multicentre, randomised, controlled, phase 3, non-inferiority trial.Lancet (London, England) · 2017Trial
- Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial.Clinics (Sao Paulo, Brazil) · 2017Trial
- Trial
- Swedish prospective multicenter trial on the accuracy and clinical relevance of sentinel lymph node biopsy before neoadjuvant systemic therapy in breast cancer.Breast cancer research and treatment · 2017Trial
- Association between sentinel lymph node number and prognosis in cT1-2N0M0 early breast cancer patients with negative sentinel lymph nodes: a single‑center retrospective cohort study.Annals of medicine · 2026Article
- Optimizing axillary surgery for patients with clinically node-negative and node-positive breast cancer.Surgery today · 2026Review
- Oncological outcomes of omitting axillary lymph node dissection in breast cancer patients with sentinel lymph node micrometastasis undergoing mastectomy without radiotherapy.Surgery today · 2026Article
- Economic and Health System Impact of Implementing the SOUND Trial Approach in Early-Stage Breast Cancer.Annals of surgical oncology · 2026Article
146 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectiveThe early results of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial demonstrated no difference in locoregional recurrence for patients with positive sentinel lymph nodes (SLNs) randomized either to axillary lymph node dissection (ALND) or sentinel lymph node dissection (SLND) alone. We now report long-term locoregional recurrence results.
methodsACOSOG Z0011 prospectively examined overall survival of patients with SLN metastases undergoing breast-conserving therapy randomized to undergo ALND after SLND or no further axillary specific treatment. Locoregional recurrence was prospectively evaluated and compared between the groups.
resultsFour hundred forty-six patients were randomized to SLND alone and 445 to SLND and ALND. Both groups were similar with respect to age, Bloom-Richardson score, Estrogen Receptor status, adjuvant systemic therapy, histology, and tumor size. Patients randomized to ALND had a median of 17 axillary nodes removed compared with a median of only 2 SLNs removed with SLND alone (P < 0.001). ALND, as expected, also removed more positive lymph nodes (P < 0.001). At a median follow-up of 9.25 years, there was no statistically significant difference in local recurrence-free survival (P = 0.13). The cumulative incidence of nodal recurrences at 10 years was 0.5% in the ALND arm and 1.5% in the SLND alone arm (P = 0.28). Ten-year cumulative locoregional recurrence was 6.2% with ALND and 5.3% with SLND alone (P = 0.36).
conclusionDespite the potential for residual axillary disease after SLND, SLND without ALND offers excellent regional control for selected patients with early metastatic breast cancer treated with breast-conserving therapy and adjuvant systemic therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.