Study Urges Against Lymph Node Dissection for Abemaciclib in ER-Positive Breast Cancer

For this purpose, 2766 patients were enrolled between Jan 31, 2015, and Dec 31, 2021, for a randomised, phase 3, SENOMAC trial. Patients aged 18 years or older, regardless of performance status, who had clinically node-negative T1–T3 breast cancer with one or two sentinel node macrometastases, were recruited from 67 sites across five European countries. These patients were randomly assigned in a 1:1 ratio using permuted block randomization.

The study reveals that:

• 1705 (67%) is found eligible for this post-hoc study, in which 802 (47%) had a cALND and 903 (53%) had a sentinel lymph node biopsy only.
• Median age was 62 years (IQR 52–71), 1699 (>99%) of 1705 patients were female, and six (<1%) were male.
• 1342 patients responded to questionnaires, after a follow-up of 45·2 months, reported severe or very severe impairment of physical arm function was reported in 84 (13%) of 634 patients who had cALND versus 30 (4%) of 708 who had sentinel lymph node biopsy only.

“cALND poses a significant risk of severe arm complications, and therefore, its use should not be recommended,” researchers concluded.

Reference: de Boniface, J., Appelgren, M., Szulkin, R., Alkner, S., Andersson, Y., Bergkvist, L., Frisell, J., Gentilini, O. D., Kontos, M., Kühn, T., Lundstedt, D., Offersen, B. V., Olofsson Bagge, R., Reimer, T., Sund, M., Christiansen, P., Rydén, L., & Tvedskov, T. F. (2024). Completion axillary lymph node dissection for the identification of pN2–3 status as an indication for adjuvant CDK4/6 inhibitor treatment: A post-hoc analysis of the randomised, phase 3 SENOMAC trial. The Lancet Oncology. Advance online publication. https://doi.org/10.1016/S1470-2045(24)00350-4