Dr. Morrow Describes the ACOSOG Z11 Trial

Monica Morrow, MD, chief, Breast Service, Department of Surgery; Anne Burnett Windfohr Chair of Clinical Oncology, Memorial Sloan-Kettering Cancer Center, discusses the American College of Surgeons Oncology Group (ACOSOG) Z11 trial that sought to establish whether the elimination of axillary dissection was beneficial to patients.

The Z11 trial was a prospective randomized trial for patients with T1 and T2 clinically node negative breast cancer, with positive sentinel nodes, treated with breast conserving surgery, and whole breast irradiation.

After a 6.3-year follow-up the trial found that patients receiving axillary node dissection experienced 0.4% recurrence rates compared to 0.9% that did not. These findings did not establish a significant difference at preventing recurrence or improving survival between the two groups.

These findings hold true only for the group examined in the trial. It is not suggested for patients undergoing a mastectomy or partial breast irradiation. The cancer cannot be locally advanced, have positive lymph nodes, or undergone neoadjuvant chemotherapy.