Patients with breast cancer that has started to spread to the lymph nodes in the armpit can safely avoid extensive removal of the lymph nodes if their treatment is tailored to their response to cancer-killing therapies such as chemotherapy before surgery.
Mar 22 2024European Organisation for Research and Treatment of Cancer
Dr Van Hemert and colleagues, led by Professor Marie-Jeanne Vrancken Peeters at the AVL-NKI, carried out a study involving 218 patients between 2014 and 2021 to investigate cancer outcomes of the MARI protocol . The protocol was developed at the AVL Hospital in 2014 and is now being used in several Dutch hospitals. Today's presentation gives outcomes after four years for the rate of cancer recurrence in the axillary nodes, patients' overall survival and disease-free survival.
"Whenever the MARI node showed there were no residual tumor cells, in other words a pathological complete response to the primary systemic treatment, then we did not remove any additional lymph nodes. Patients who had residual disease in the MARI node had further lymph nodes removed: known as an axillary lymph node dissection. All patients received radiation treatment."
Related StoriesThe axillary recurrence rate in the 115 patients who required further lymph node removal was 3.5%, with an overall survival rate of 90% and a disease-free survival rate of 82%. The researchers will be collecting further data on outcomes over a longer period. They have also started the DESCARTES trial to investigate the safety of omitting radiation treatment in a selected group of patients with tumors smaller than two centimeters in diameter, no evidence of the cancer spreading to the lymph nodes and pCR after primary systemic treatment.
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