Sentinel-Lymph-Node-Based management or routine axillary clearance? One-year outcomes of sentinel node biopsy versus axillary clearance (SNAC): A randomized controlled surgical trial

Gill, G., The SNAC Trial Group of the Royal Australasian College of Surgeons, NHMRC Trials Centre and Ung, Owen (2009) Sentinel-Lymph-Node-Based management or routine axillary clearance? One-year outcomes of sentinel node biopsy versus axillary clearance (SNAC): A randomized controlled surgical trial. Annals of Surgical Oncology, 16 2: 266-275. doi:10.1245/s10434-008-0229-z


Author Gill, G.
The SNAC Trial Group of the Royal Australasian College of Surgeons
NHMRC Trials Centre
Ung, Owen
Title Sentinel-Lymph-Node-Based management or routine axillary clearance? One-year outcomes of sentinel node biopsy versus axillary clearance (SNAC): A randomized controlled surgical trial
Journal name Annals of Surgical Oncology   Check publisher's open access policy
ISSN 1068-9265
1534-4681
Publication date 2009-02-01
Year available 2009
Sub-type Article (original research)
DOI 10.1245/s10434-008-0229-z
Volume 16
Issue 2
Start page 266
End page 275
Total pages 10
Editor Balch, C. M.
Place of publication New York, United States
Publisher Springer New York LLC
Collection year 2010
Language eng
Subject C1
Abstract We sought the extent to which arm morbidity could be reduced by using sentinel-lymph-node-based management in women with clinically node-negative early breast cancer. One thousand eighty-eight women were randomly allocated to sentinel-lymph-node biopsy followed by axillary clearance if the sentinel node was positive or not detected (SNBM) or routine axillary clearance (RAC, sentinel-lymph-node biopsy followed immediately by axillary clearance). Sentinel nodes were located using blue dye, alone or with technetium-labeled antimony sulfide colloid. The primary endpoint was increase in arm volume from baseline to the average of measurements at 6 and 12 months. Secondary endpoints were the proportions of women with at least 15% increase in arm volume or early axillary morbidity, and average scores for arm symptoms, dysfunctions, and disabilities assessed at 6 and 12 months by patients with the SNAC Study-Specific Scales and other quality-of-life instruments. Sensitivity, false-negative rates, and negative predictive values for sentinel-lymph-node biopsy were estimated in the RAC group. The average increase in arm volume was 2.8% in the SNBM group and 4.2% in the RAC group (P = 0.002). Patients in the SNBM group gave lower ratings for arm swelling (P < 0.001), symptoms (P < 0.001), and dysfunctions (P = 0.02), but not disabilities (P = 0.5). Sentinel nodes were found in 95% of the SNBM group (29% positive) and 93% of the RAC group (25% positive). SNB had sensitivity 94.5%, false-negative rate 5.5%, and negative predictive value 98%. SNBM was successfully undertaken in a wide range of surgical centers and caused significantly less morbidity than RAC. A full list of contributors is provided in the Appendix.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 114 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 138 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 08 Apr 2010, 20:36:52 EST by Maree Knight on behalf of Medicine - Princess Alexandra Hospital