Axillary dissection versus radiotherapy in sentinel node positive breast cancer: a meta-analysis of long-term recurrence and survival

Abstract While select early-stage breast cancer patients with a positive sentinel node may avoid further treatment in line with ACOSOG Z-0011, the optimal treatment for ineligible patients remains unclear. The AMAROS and OTOASAR trials compared axillary lymph node dissection (ALND) and axillary nodal radiotherapy (ANR) in sentinel-node positive patients. Our meta-analysis demonstrated reduced overall recurrence with ALND compared to ANR (pOR: 0.74, 95% CI: 0.34-1.60, p=0.441), however this was not statistically significant. There was no difference in overall or disease-free survival. As a result, both may be appropriate treatment modalities for sentinel-node positive patients as part of an individualized treatment approach.