{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T11:33:04Z","timestamp":1768822384288,"version":"3.49.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The aim was to determine long-term overall, breast cancer-specific and metastasis-free survival as well as axillary relapse rate from a pooled analysis of two randomized trials in women with operable breast cancer. These trials compared axillary node sampling (ANS), combined with axillary radiotherapy (AXRT) if the sampled nodes were involved, with axillary node clearance (ANC).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Data from two clinical trials at the Edinburgh Breast Unit that randomized patients between 1980 and 1995 were pooled. Long-term survival was analysed using Kaplan\u2013Meier curves and Cox regression, with separate analyses for patients with node-positive (ANS + AXRT versus ANC) and node-negative (ANS versus ANC) disease.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 855 women randomized, 799 were included in the present analysis after a median follow-up of 19\u00b74 years. Some 301 patients (37\u00b77 per cent) had node-positive disease. There was no evidence of a breast cancer survival advantage for ANS versus ANC in patients with node-negative disease (hazard ratio (HR) 0\u00b788, 95 per cent c.i. 0\u00b758 to 1\u00b734; P = 0\u00b7557), or for ANS + AXRT versus ANC in those with node-positive breast cancer (HR 1\u00b707, 0\u00b777 to 1\u00b750; P = 0\u00b7688). There was no metastasis-free survival advantage for ANS versus ANC in patients with node-negative tumours (HR 1\u00b703, 0\u00b770 to 1\u00b751; P = 0\u00b7877), or ANS + AXRT versus ANC in those with node-positive disease (HR 1\u00b703, 0\u00b775 to 1\u00b743; P = 0\u00b7847). Node-negative patients who underwent ANS had a higher risk of axillary recurrence than those who had ANC (HR 3\u00b753, 1\u00b729 to 9\u00b763; P = 0\u00b7014). Similarly, among women with node-positive tumours, the risk of axillary recurrence was greater after ANS + AXRT than ANC (HR 2\u00b764, 1\u00b700 to 6\u00b795; P = 0\u00b7049).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Despite a higher rate of axillary recurrence with ANS combined with radiotherapy to the axilla, ANC did not improve overall, breast cancer-specific or metastasis-free survival. Axillary recurrence is thus not a satisfactory endpoint when comparing axillary treatments.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/bjs.9952","type":"journal-article","created":{"date-parts":[[2015,12,22]],"date-time":"2015-12-22T03:59:15Z","timestamp":1450756755000},"page":"81-87","source":"Crossref","is-referenced-by-count":13,"title":["Pooled long-term outcomes from two randomized trials of axillary node sampling with axillary radiotherapy versus<\/i> axillary node clearance in patients with operable node-positive breast cancer"],"prefix":"10.1093","volume":"103","author":[{"given":"A U","family":"Bing","sequence":"first","affiliation":[{"name":"Edinburgh Breast Unit, University of Edinburgh , Edinburgh,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G R","family":"Kerr","sequence":"additional","affiliation":[{"name":"Oncology Department, Western General Hospital , Edinburgh,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W","family":"Jack","sequence":"additional","affiliation":[{"name":"Edinburgh Breast Unit, University of Edinburgh , Edinburgh,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U","family":"Chetty","sequence":"additional","affiliation":[{"name":"Edinburgh Breast Unit, University of Edinburgh , Edinburgh,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L J","family":"Williams","sequence":"additional","affiliation":[{"name":"Centre for Population Health Sciences, University of Edinburgh , Edinburgh,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Rodger","sequence":"additional","affiliation":[{"name":"Edinburgh Breast Unit, University of Edinburgh , Edinburgh,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J M","family":"Dixon","sequence":"additional","affiliation":[{"name":"Edinburgh Breast Unit, University of Edinburgh , Edinburgh,","place":["UK"]},{"name":"Breast Cancer Now Research Unit, University of Edinburgh , Edinburgh,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2016,1,1]]},"reference":[{"key":"2024092914073045900_bjs9952-bib-0001","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1056\/NEJM199306033282202","article-title":"Radiotherapy after breast-preserving surgery in women with localised cancer of the breast","volume":"328","author":"Veronesi","year":"1993","journal-title":"N Engl J Med"},{"key":"2024092914073045900_bjs9952-bib-0002","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/jso.2930510105","article-title":"Axillary node dissection for early breast cancer: some is good, but all is better","volume":"51","author":"Moffat","year":"1992","journal-title":"J Surg Oncol"},{"key":"2024092914073045900_bjs9952-bib-0003","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.ejso.2006.04.019","article-title":"Comparative study of lymphoedema with axillary node dissection versus axillary node sampling with radiotherapy in patients undergoing breast conservation surgery","volume":"32","author":"Mathew","year":"2006","journal-title":"Eur J Surg Oncol"},{"key":"2024092914073045900_bjs9952-bib-0004","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1002\/bjs.1800760613","article-title":"Arm morbidity within trial of mastectomy and either nodal sample with selective radiotherapy or axillary clearance","volume":"76","author":"Aitken","year":"1989","journal-title":"Br J Surg"},{"key":"2024092914073045900_bjs9952-bib-0005","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1093\/jnci\/djj158","article-title":"Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial [Erratum]","volume":"98","author":"Mansel","year":"2006","journal-title":"J Natl Cancer Inst"},{"key":"2024092914073045900_bjs9952-bib-0006","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1046\/j.1365-2168.2000.01345.x","article-title":"Management of the axilla in operable breast cancer treated by breast conservation: a randomised clinical trial","volume":"87","author":"Chetty","year":"2000","journal-title":"Br J Surg"},{"key":"2024092914073045900_bjs9952-bib-0007","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1002\/bjs.1800821118","article-title":"The Edinburgh randomized trial of axillary sampling or clearance after mastectomy","volume":"82","author":"Forrest","year":"1995","journal-title":"Br J Surg"},{"key":"2024092914073045900_bjs9952-bib-0008","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/S0140-6736(96)02133-2","article-title":"Randomised controlled trial of conservation therapy for breast cancer: 6-year analysis of the Scottish trial. 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