Journal Article

Clinically node negative breast cancer patients undergoing breast conserving therapy, sentinel lymph node procedure versus follow-up: a Dutch randomized controlled multicentre trial (BOOG 2013-08)

Vane, M. L. G., Kessels, A. G. H., van Roozendaal, L. M., de Wilt, J. H. W., van Dalen, T., Boersma, L. J., Lobbes, M. B. I., Tjan-Heijnen, V. C. G., van der Hage, J. A., de Vries, J., Smidt, M. L., Van de Vijver, K. K. B. T., Westenberg, A. H., Strobbe, L. J. A., Linn, S. C., Poortmans, P. M. P.

2017

Overview

Background Studies showed that axillary lymph node dissection can be safely omitted in presence of positive sentinel lymph node(s) in breast cancer patients treated with breast conserving therapy. Since the outcome of the sentinel lymph node biopsy has no clinical consequence, the value of the procedure itself is being questioned. The aim of the BOOG 2013–08 trial is to investigate whether the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients treated with breast conserving therapy. Methods The BOOG 2013–08 is a Dutch prospective non-inferiority randomized multicentre trial. Women with pathologically confirmed clinically node negative T1–2 invasive breast cancer undergoing breast conserving therapy will be randomized for sentinel lymph node biopsy versus no sentinel lymph node biopsy. Endpoints include regional recurrence after 5 (primary endpoint) and 10 years of follow-up, distant-disease free and overall survival, quality of life, morbidity and cost-effectiveness. Previous data indicate a 5-year regional recurrence free survival rate of 99% for the control arm and 96% for the study arm. In combination with a non-inferiority limit of 5% and probability of 0.8, this result in a sample size of 1.644 patients including a lost to follow-up rate of 10%. Primary and secondary endpoints will be reported after 5 and 10 years of follow-up. Discussion If the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients undergoing breast conserving therapy, this study will cost-effectively lead to a decreased axillary morbidity rate and thereby improved quality of life with non-inferior regional control, distant-disease free survival and overall survival. Trial registration The BOOG 2013–08 study is registered in ClinicalTrials.gov since October 20, 2014, Identifier: NCT02271828. https://clinicaltrials.gov/ct2/show/NCT02271828

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Biomedical and Life Sciences / Biomedicine / Biopsy / Breast cancer / Breast conserving therapy / Breast neoplasms / Breast Neoplasms - pathology / Breast Neoplasms - surgery / cancer imaging / Cancer Research / Cancer therapies / Care and treatment / Combined Modality Therapy - adverse effects / Combined Modality Therapy - methods / Diagnosis / Female / Follow-Up Studies / Health Promotion and Disease Prevention / Humans / interventional therapeutics / Invasiveness / Lymph / Lymph node biopsy / Lymph nodes / Lymphatic Metastasis / Lymphatic system / Mastectomy / Mastectomy, Segmental - adverse effects / Mastectomy, Segmental - methods / Medical research / Medicine/Public Health / Metastasis / Methods / Morbidity / Neoplasm Recurrence, Local / Neoplasm Staging / Netherlands / Oncology / Quality of Life / Radiation therapy / Retreatment / Sentinel Lymph Node - pathology / Sentinel Lymph Node Biopsy / Studies / Study Protocol / Surgery / Surgical Oncology / Survival / Treatment Outcome / Ultrasonic imaging / Watchful Waiting