Therefore, it remains uncertain whether it is safe to omit both Sentinel Lymph Node Biopsy (SLNB) and radiation therapy (RT) for low-risk disease in elderly patients. However, it's worth noting that 37% of patients in the study are aged over 65 years, and for this age group, radiation therapy can typically be omitted, as supported by recent findings from the PRIME trial and LUMINA study . By identifying low-risk cases more accurately, these genomic tests contribute to the assessment of whether Sentinel Lymph Node Dissection (SLND) may be deemed unnecessary, thus allowing for more personalized and targeted treatment strategies.įurthermore, the study population's heterogeneity adds complexity to treatment decisions, with potential variations in outcomes and needs across different patient profiles based on age, menopausal status, and molecular subtype making it challenging to determine which specific patient groups can safely omit Sentinel Lymph Node Dissection (SLND).Īll patients in the study received adjuvant radiation therapy. While one of the key aims behind the omission of Sentinel Lymph Node Biopsy (SLNB) in breast cancer is to enhance the overall quality of life (QoL) for patients, it's noteworthy that the current trial does not specifically measure QoL as either a primary or secondary endpoint which is a significant consideration when making treatment decisions.Īdvances in biological and genetic profiling of tumors have opened up more precise avenues for identifying patients with low-risk breast cancer than relying solely on traditional histopathological features, as observed in the current study. Nonetheless, omitting Sentinel Lymph Node Dissection (SLND) in cases of small tumor breast cancer is a nuanced decision guided by several crucial factors. Oreste Davide Gentilini and colleagues suggest that the five-year outcomes of the SOUND trial, a prospective non inferiority phase 3 randomized clinical trial,demonstrate comparable results in terms of both locoregional relapse and distant disease-free survival (DFS) whether Sentinel Lymph Node Dissection (SLND) is performed or omitted to patients of any age with breast cancer (BC) tumors up to 2 cm in size and a negative preoperative axillary ultrasonography result. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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