Implications for Axillary Radiation Following Review of the ACOSOG Z11 Trial

Judy C. Boughey, MD, associate professor of surgery, director, Breast Surgical Oncology Training Program, Mayo Clinic, discusses implications for axillary radiation following review of the ACOSOG Z11 trial.

Clinical Pearls:

• Data from the study suggested that the patients should not receive radiation directed towards the axilla, but no data was collected on how the patients were treated.
• A recent study in which ACOSOG researchers looked at radiation reports showed that the majority of patients were treated with standard tangents and not with definitive radiation to the axilla. In the study, 89% of patients received radiation to the breast and about 15% had definitive radiation to the supraclavicular area.
• A small subset of 200 patients from the study showed no difference in the radiation field planning between the group that was randomized to sentinel node only and the group that underwent axillary lymph node dissection.
• While this information is encouraging, it is too small of a group to provide a definitive answer.