Overview
- The Phase III BOOG 2013-08 trial randomized 1,733 clinically node-negative patients to sentinel lymph node biopsy or omission during breast-conserving surgery across 25 hospitals in the Netherlands from 2015 to 2022.
- At a median five years, regional nodal recurrence was 0.5% with biopsy versus 1.2% without, and regional recurrence-free survival was 96.6% versus 94.2%, with no statistically significant differences.
- Findings presented at the San Antonio Breast Cancer Symposium apply chiefly to hormone receptor–positive, HER2-negative disease, which represented 86.6% of the cohort, with strongest relevance to tumors 2 cm or smaller.
- All patients received whole-breast radiation, and presenters cautioned that safety of omission with contemporary partial-breast radiation has not been established.
- Endocrine therapy was given to roughly half of eligible patients (48.6% with biopsy, 46.6% without), prompting calls for longer follow-up for late recurrences and supporting potential benefits of omission such as fewer complications, shorter care, and lower costs.