Breast Cancer Clinical Trial
Official title:
A Prospective Randomized Multicenter Phase III Study of Axillary Lymph Node Dissection Versus no Dissection in Breast Cancer With Positive Sentinel Lymph Node--the Validation of Z0011 in China
The recently randomized trial (ASCOG Z0011) support that among patients with limited sentinel
lymph node (SLN) metastatic breast cancer treated with breast conservation and systemic
therapy, the use of sentinel lymph node biopsy (SLNB) alone compared with axillary lymph node
dissection (ALND) did not result in inferior survival. These patients, therefore, are
unlikely to benefit from further surgery that results in a longer period of hospitalization,
higher costs and higher postoperative morbidity. This result has been written in the 2012
National Comprehensive Cancer Network Clinical Practice Guidelines.
However, Limitations of Z0011, such as failure to achieve target accrual and possible
randomization imbalance favoring the SLNB-alone group, must be considered. In the other hand,
further testing in different country are needed.
The investigators design and begin a prospective randomized multicenter phase III study of
ALND vs. no ALND in breast Cancer with positive SLN--the validation of Z0011 in China.
OBJECTIVES:
To determine the effects of complete axillary lymph node dissection (ALND) on survival of
patients with sentinel lymph node (SLN) metastasis of breast cancer.
OUTLINE: This is a randomized multicenter study. Before randomization, all women were
stratified according to age (≤50 years, >50 years), tumor size(≤2cm, >2cm) and research
center. All the patients underwent lumpectomy and sentinel lymph node biopsy (SLNB). Eligible
women were randomly assigned to ALND or no ALND Active Comparator: Patients undergo axillary
lymph node dissection involving removal of at least level I and II nodes.
Experimental: No surgery of axillary lymph node in this arm. All the patients were to receive
whole-breast opposing tangential-field radiation therapy. The use of adjuvant systemic
therapy was determined by the treating physician according to the recently NCCN.
Patients are followed up every 4 months for the first 2 years, every 6 months from the third
year to the fifth year, and then annually for a total of 10 years.
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