ArticleThe British journal of surgery2024
De-escalation of axillary treatment in the event of a positive sentinel lymph node biopsy in cT1-2 N0 breast cancer treated with mastectomy: nationwide registry study (BOOG 2013-07).
Article in The British journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Can axillary lymph node dissection be omitted in breast cancer patients with 1-2 positive sentinel nodes? A systematic review and meta-analysis.The oncologist · 2025Pooled it
- Safety analysis of omitting axillary lymph node dissection in early-stage breast cancer with 1-2 sentinel lymph nodes macro-metastases: a meta-analysis.Frontiers in oncology · 2025Pooled it
- Omitting axillary dissection in breast cancer patients with one to two positive sentinel nodes undergoing mastectomy: a retrospective and prospective cohort study with a target trial emulation.International journal of surgery (London, England) · 2026Article
- Axillary Surgery in Breast Cancer: Evidence-Based De-escalation Across Upfront and Post-Neoadjuvant Settings.Journal of breast cancer · 2026Review
- Is sentinel lymph node frozen section analysis necessary in hormone receptor-positive, HER2-negative, clinically node-negative breast cancer patients undergoing upfront mastectomy?Frontiers in oncology · 2026Article
- From Axillary Lymph Node Dissection to Sentinel Node Biopsy in Breast Cancer: A 23-Year Population-Based Large-Sample Study with Long-Term Survival Outcomes.Breast cancer (Dove Medical Press) · 2026Article
- Intraoperative frozen section analysis can be omitted in early breast cancer without significantly elevating reoperation rates.BMC surgery · 2025Article
- Axillary Management for Patients Undergoing Total Mastectomy and a Positive Sentinel Lymph Node: Is Axillary Dissection Necessary?World journal of surgery · 2025Article
- Omission of Routine Frozen Section for Clinically Node-Negative Patients Undergoing Upfront Mastectomy Avoids Unnecessary Axillary Treatment.Annals of surgical oncology · 2025Article
- Real Index of Refraction of Normal and Cancerous Axillary Lymph Nodes in Breast Cancer Patients: Results from an Experimental Study.Journal of personalized medicine · 2025Article
- Predicting the axillary lymph node tumor burden in breast cancer patients using ultrasonic radiomics nomogram model.PloS one · 2025Article
- Escalation and De-Escalation of Adjuvant Radiotherapy in Early Breast Cancer: Strategies for Risk-Adapted Optimization.Cancers · 2024Review
Corrections and comments
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Authors and funding
20 authors at 11 institutions in 2 countries.
Funding
Abstract
backgroundTrials have demonstrated the safety of omitting completion axillary lymph node dissection in patients with cT1-2 N0 breast cancer operated with breast-conserving surgery who have limited metastatic burden in the sentinel lymph node. The aim of this registry study was to provide insight into the oncological safety of omitting completion axillary treatment in patients operated with mastectomy who have limited-volume sentinel lymph node metastasis.
methodsWomen diagnosed in 2013-2014 with unilateral cT1-2 N0 breast cancer treated with mastectomy, with one to three sentinel lymph node metastases (pN1mi-pN1a), were identified from the Netherlands Cancer Registry, and classified by axillary treatment: no completion axillary treatment, completion axillary lymph node dissection, regional radiotherapy, or completion axillary lymph node dissection followed by regional radiotherapy. The primary endpoint was 5-year regional recurrence rate. Secondary endpoints included recurrence-free interval and overall survival, among others.
resultsIn total, 1090 patients were included (no completion axillary treatment, 219 (20.1%); completion axillary lymph node dissection, 437 (40.1%); regional radiotherapy, 327 (30.0%); completion axillary lymph node dissection and regional radiotherapy, 107 (9.8%)). Patients in the group without completion axillary treatment had more favourable tumour characteristics and were older. The overall 5-year regional recurrence rate was 1.3%, and did not differ significantly between the groups. The recurrence-free interval was also comparable among groups. The group of patients who did not undergo completion axillary treatment had statistically significantly worse 5-year overall survival, owing to a higher percentage of non-cancer deaths.
conclusionIn this registry study of patients with cT1-2 N0 breast cancer treated with mastectomy, with low-volume sentinel lymph node metastasis, the 5-year regional recurrence rate was low and comparable between patients with and without completion axillary treatment.
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Registered trials
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