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Updated: Jun 10, 2025
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Assessment of Audio-Tactile Sensory Substitution Training in Participants with Profound Deafness Using the Event-Related Potential Technique
Published on: September 7, 2022
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Real-World Implications of the SOUND Trial
Andreas Giannakou1,2,3, Olga Kantor1,2,3, Ko Un Park1,2,3
1Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Annals of Surgical Oncology
|October 14, 2024
Summary
Omission of sentinel lymph node biopsy (SLNB) is safe for early-stage, hormone receptor-positive, HER2-negative breast cancer patients. Real-world data shows similar outcomes to the SOUND trial, supporting its wider adoption.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- The SOUND trial established non-inferiority of omitting sentinel lymph node biopsy (SLNB) versus axillary staging for early breast cancer (BC) with negative axillary ultrasound (AxUS).
- Generalizability of these findings to hormone receptor-positive (HR+), HER2-negative (HER2-) BC requires examination.
Purpose of the Study:
- To assess the oncologic outcomes and nodal disease burden in a real-world cohort of HR+HER2- BC patients meeting SOUND trial eligibility criteria.
- To evaluate the impact of nodal status and recurrence score on chemotherapy recommendations in postmenopausal patients.
Main Methods:
- Retrospective analysis of 312 HR+HER2- BC patients with cT1N0M0 and negative AxUS, who underwent SLNB.
- Comparison of clinicopathologic characteristics, disease burden, and oncologic outcomes with the SLNB arm of the SOUND trial.
- Analysis of chemotherapy recommendations based on nodal status and 21-gene recurrence score in postmenopausal women.
Main Results:
- Of 312 eligible patients, 12.2% had positive SLNB, with only 0.4% having ≥4 positive nodes.
- No axillary recurrences and one distant recurrence (0.3%) were observed at a median follow-up of 26.2 months.
- In postmenopausal women with recurrence score ≤25, chemotherapy recommendations were independent of nodal status.
Conclusions:
- Real-world HR+HER2- BC patients meeting SOUND criteria exhibit similar nodal disease burden and oncologic outcomes to the trial population.
- Omission of SLNB appears feasible and safe in this subgroup, supporting clinical implementation.
- SLNB omission does not seem to affect adjuvant chemotherapy decisions in postmenopausal patients with low recurrence scores.
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