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Table 1 Clinical trials evaluating axillary lymph node dissection in clinically node-negative patients. Summary of trials evaluating the role of axillary lymph node dissection in patients presenting with no clinical evidence of axillary lymphadenopathy

From: Targeting and limiting surgery for patients with node-positive breast cancer

Trial Breast surgery Number of positive sentinel lymph nodes allowed Randomization groups Number 5-year locoregional recurrence 5-years overall survival
ACOSOG Z0011 [4, 14] BCT 1-2 ALND 420 1.6 % 91.9 %
No ALND a 436 3.1 % 92.5 %
AMAROS [5] BCT or Mastectomy No limit ALND 744 Axillary recurrence 0.43 % 93.3 %
Axillary RT 682 1.19 % 92.5 %
IBCSG 23-01 [6] BCT or Mastectomy No limit- all metastases had to be ≤2 mm ALND 464 2.4 % 97.6 %
No ALND a 467 2.8 % 97.5 %
  1. aNo axillary RT allowed
  2. BCT, Breast conservation therapy; ALND, Axillary lymph node dissection; RT, Radiotherapy