Iodine Seed−Marking Protocol for Response-Guided Axillary Treatment After Systemic Therapy for Node-Positive Breast Cancer

Is it safe to omit axillary treatment in patients with breast cancer and limited axillary nodal disease who experienced nodal pathologic complete response (pCR) after primary systemic treatment (PST)?This cohort study of 350 patients with node-positive breast cancer undergoing PST using the MARI (marking the axillary lymph node with a radioactive iodine seed) protocol found that after 49 months of follow-up, the 135 patients (39%) who experienced pCR and no further axillary treatment had an axillary recurrence rate of 0.7% (95% CI, 0.04%-4.1%) with excellent 5-year survival data.These findings suggest that response-guided axillary treatment based on the MARI protocol for patients with limited nodal disease was associated with a very low risk of axillary recurrence and should be considered in patients with node-positive breast cancer who experienced nodal pCR after PST.

Corresponding Author: Marie-Jeanne T. F. D. Vrancken Peeters, MD, PhD, Department of Surgical Oncology, Netherlands Cancer Institute−Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands (m.vrancken@nki.nl).

Link to the article in your story

We encourage you to link out to this article in your story using the link below. It includes an access token that will give free access to the article for your readers up to one year after publication. (The link will be live after the article publishes and embargo is lifted.)

Please see the article for additional information, including full author list, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

Need more information? Contact us.