articleJNCI Journal of the National Cancer InstituteMay 2, 2006Closed access

Randomized Multicenter Trial of Sentinel Node Biopsy Versus Standard Axillary Treatment in Operable Breast Cancer: The ALMANAC Trial

Cardiff University · Queen Elizabeth Hospital Birmingham · +11 more institutions

PubMed
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Abstract

Background

Sentinel lymph node biopsy in women with operable breast cancer is routinely used in some countries for staging the axilla despite limited data from randomized trials on morbidity and mortality outcomes. We conducted a multicenter randomized trial to compare quality-of-life outcomes between patients with clinically node-negative invasive breast cancer who received sentinel lymph node biopsy and patients who received standard axillary treatment.

Methods

The primary outcome measures were arm and shoulder morbidity and quality of life. From November 1999 to October 2003, 1031 patients were randomly assigned to undergo sentinel lymph node biopsy (n = 515) or standard axillary surgery (n = 516). Patients with sentinel lymph node metastases proceeded to delayed axillary clearance or received axillary radiotherapy (depending on the protocol at the treating institution). Intention-to-treat analyses of data at 1, 3, 6, and 12 months after surgery are presented. All statistical tests were two-sided.

Citation impact

1,673
total citations
FWCI
39.54
Percentile
100%
References
39
Citations per year

Authors

19

Topics & keywords

Keywords
  • Medicine
  • Sentinel node
  • Randomized controlled trial
  • Breast cancer
  • Multicenter trial
  • Biopsy
  • Oncology
  • Internal medicine
UN Sustainable Development Goals
  • Good health and well-being
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