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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Sentinel lymph node biopsy (SLNB) is standard for staging the axilla in early breast cancer.
  • The SOUND trial suggested omitting SLNB in specific low-risk patients.
  • Real-world data is needed to validate these findings.

Purpose of the Study:

  • To evaluate nodal disease burden and oncologic outcomes in real-world patients with HR+HER2- breast cancer who met SOUND trial eligibility criteria.
  • To compare these outcomes with the SLNB arm of the original SOUND trial.
  • To assess the feasibility of omitting SLNB in this population.

Main Methods:

  • Retrospective analysis of 312 real-world patients with HR+HER2- breast cancer.
  • Patients met eligibility criteria similar to the SOUND trial.
  • Comparison of nodal disease burden and oncologic outcomes (e.g., recurrence, survival) with historical SOUND trial SLNB arm data.

Main Results:

  • Nodal disease burden in the real-world cohort was comparable to the SOUND trial SLNB arm.
  • Oncologic outcomes, including recurrence rates and survival, were similar between the real-world cohort and the SOUND trial SLNB arm.
  • No significant differences in key outcomes were observed, suggesting comparable safety.

Conclusions:

  • Omission of SLNB in carefully selected HR+HER2- breast cancer patients meeting SOUND criteria is supported by real-world data.
  • These findings suggest that SLNB can be safely omitted in this specific patient population.
  • Supports the careful implementation of de-escalation strategies in breast cancer management.