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[Sentinel node invasion: is it necessary to perform axillary lymph node dissection? Randomized trial SERC].

Gilles Houvenaeghel1, Michel Resbeut2, Jean-Marie Boher2

  • 1Institut Paoli-Calmettes et CRCM 232, boulevard Sainte-Marguerite, 13273 Marseille cedex 9, France, Université Aix-Marseille, 27, bd Jean-Moulin, 13385 Marseille cedex 5, France.

Bulletin Du Cancer
|May 6, 2014
PubMed
Summary

Axillary lymph node dissection omission is being questioned for early-stage breast cancer. A new trial will compare observation versus dissection for positive sentinel nodes to determine if omitting dissection is a safe new standard.

Keywords:
axillary lymph node dissectionbreast cancerrandomised trialsentinel node

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Clinical Trials

Context:

  • Axillary lymph node dissection (ALND) is a standard procedure for breast cancer staging.
  • Its necessity is increasingly questioned for specific patient subgroups, including those with positive sentinel nodes (SN).
  • Current evidence is insufficient to support omitting ALND as a new standard of care.

Purpose:

  • To justify the need for a prospective randomized trial investigating ALND omission in breast cancer.
  • To present the design of the proposed Sentinelle Envahi et Randomisation du Curage (SERC) trial.
  • To evaluate the impact of ALND omission on oncological outcomes.

Summary:

  • The SERC trial will randomize patients with positive SN to either observation or completion ALND.
  • It aims to demonstrate the non-inferiority of omitting ALND compared to performing it.
  • Key endpoints include the rate of non-sentinel node involvement, axillary recurrence, disease-free survival, and adjuvant treatment decisions.

Impact:

  • This trial could redefine the standard of care for sentinel node-positive breast cancer patients.
  • Findings will inform clinical decision-making regarding the extent of axillary staging.
  • Potential to reduce surgical morbidity associated with ALND without compromising oncological safety.