{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:59:28Z","timestamp":1785121168339,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Axillary surgery in breast cancer has undergone progressive de\u2010escalation. The recent Sentinel Node versus Observation after Axillary Ultrasound (SOUND) and Intergroup Sentinel Mamma (INSEMA) trials have demonstrated that sentinel lymph node biopsy may be safely omitted in selected patients. This study aimed to evaluate the clinical relevance and applicability of the SOUND and INSEMA trial criteria within the Australian and New Zealand context.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Prospectively maintained data from the BreastSurgANZ Quality Audit (BQA) was analysed. Patients with invasive breast cancer treated between 2019 and 2023 who met the inclusion criteria of the SOUND and INSEMA trials were identified.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 69\u2009122 patients were treated for invasive breast cancer over the five\u2010year study period, of whom 30\u2009822 fulfilled the inclusion criteria of either the SOUND or INSEMA trials. Overall, 34.0% and 44.6% of patients with invasive breast cancer in Australia and New Zealand met the SOUND and INSEMA eligibility criteria, respectively. Tumour characteristics of BQA patients were more closely aligned with those reported in the SOUND trial than the INSEMA trial, although key differences in other clinicopathological features were observed.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The SOUND and INSEMA trial criteria are applicable to over one\u2010third of patients with invasive breast cancer in Australia and New Zealand, supporting the potential relevance of axillary surgery de\u2010escalation in this population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ans.70879","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:11:34Z","timestamp":1785118294000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Relevance of the\n SOUND<\/scp>\n and\n INSEMA<\/scp>\n Trials in Women With Early Breast Cancer in Australia and New Zealand"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7393-200X","authenticated-orcid":false,"given":"Matea","family":"Dominkovic","sequence":"first","affiliation":[{"name":"General Surgery, Blacktown and Mount Druitt Hospitals Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-6218","authenticated-orcid":false,"given":"Kerry","family":"Hitos","sequence":"additional","affiliation":[{"name":"Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1710-0919","authenticated-orcid":false,"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney Sydney New South Wales Australia"},{"name":"Westmead Breast Cancer Institute, Westmead Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1493-486X","authenticated-orcid":false,"given":"T. Michael","family":"Hughes","sequence":"additional","affiliation":[{"name":"School of Medicine and Psychology, The Australian National University Canberra Australia"},{"name":"General Surgery, Sydney Adventist Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"French","sequence":"additional","affiliation":[{"name":"General Surgery, Blacktown and Mount Druitt Hospitals Sydney New South Wales Australia"},{"name":"Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney Sydney New South Wales Australia"},{"name":"Westmead Breast Cancer Institute, Westmead Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9674-4404","authenticated-orcid":false,"given":"Nicholas","family":"Ngui","sequence":"additional","affiliation":[{"name":"General Surgery, Blacktown and Mount Druitt Hospitals Sydney New South Wales Australia"},{"name":"School of Medicine and Psychology, The Australian National University Canberra Australia"},{"name":"General Surgery, Sydney Adventist Hospital Sydney New South Wales Australia"},{"name":"School of Medicine, Western Sydney University Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"issue":"10","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/S1470-2045(10)70207-2","article-title":"Sentinel\u2010Lymph\u2010Node Resection Compared With Conventional Axillary\u2010Lymph\u2010Node Dissection in Clinically Node\u2010Negative Patients With Breast Cancer: Overall Survival Findings From the NSABP B\u201032 Randomised Phase 3 Trial","volume":"11","author":"Krag D. N.","year":"2010","journal-title":"Lancet Oncology"},{"issue":"3","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/SLA.0b013e3181f08f32","article-title":"Locoregional Recurrence After Sentinel Lymph Node Dissection With or Without Axillary Dissection in Patients With Sentinel Lymph Node Metastases: The American College of Surgeons Oncology Group Z0011 Randomized Trial","volume":"252","author":"Giuliano A. 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H.","year":"2024","journal-title":"European Journal of Breast Health"},{"issue":"10","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejso.2025.110392","article-title":"Axillary Surgery in Early Breast Cancer: Real\u2010World Analysis of the INSEMA\u2010Trial at Three Certified University Breast Cancer Centers in Germany Regarding the Omission of Sentinel Lymph Node Biopsy","volume":"51","author":"Tauber N.","year":"2025","journal-title":"European Journal of Surgical Oncology"},{"key":"e_1_2_9_15_1","first-page":"15","article-title":"Lessons From the INSEMA Trial: Is Sentinel Lymph Node Biopsy in Early\u2010Stage Breast Cancer Stepping Off the Stage?","volume":"9","author":"Chen X.","year":"2025","journal-title":"Frontiers in Oncology"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","unstructured":"T.Reimer A.Stachs K.Veselinovic et\u00a0al. \u201cPatient\u2010Reported Outcomes for the Intergroup Sentinel Mamma Study (INSEMA): A Randomised Trial With Persistent Impact of Axillary Surgery on Arm and Breast Symptoms in Patients With Early Breast Cancer \u201d55(2022):101756.","DOI":"10.1016\/j.eclinm.2022.101756"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4239"},{"issue":"1","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S1470-2045(22)00694-5","article-title":"Abemaciclib Plus Endocrine Therapy for Hormone Receptor\u2010Positive, HER2\u2010Negative, Node\u2010Positive, High\u2010Risk Early Breast Cancer (monarchE): Results From a Preplanned Interim Analysis of a Randomised, Open\u2010Label, Phase 3 Trial","volume":"24","author":"Johnston S. 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