RT Journal
A1 Wright PA, Zenilman ME
T1 LEss may be better
JF Archives of Surgery
JO Archives of Surgery
YR 2011
FD August 1
VO 146
IS 8
SP 980
OP 982
DO 10.1001/archsurg.2011.181
UL http://dx.doi.org/10.1001/archsurg.2011.181
AB 
The results of the American College of Surgeons Z0011 trial demonstrate that axillary lymph node dissection (ALND) does not improve survival in patients with breast cancer if limited metastatic disease is found in the sentinel lymph node (SLN). These new data are applicable to patients who present with T1 or T2 disease, have no palpable lymph nodes on physical examination, and undergo lumpectomy, SLN biopsy, and whole-breast radiotherapy followed by systemic therapy. This trial by Giuliano et al is practice changing and will lead to an improvement in the care we provide to our patients with breast cancer—ALND can be safely omitted in a subset of node-positive patients—with no impact on survival.