The Edinburgh randomized trial of axillary sampling or clearance after mastectomy

A. P. M. Forrest, D Everington, C. C. McDonald, R. J. Steele, U. Chetty, H. J. Stewart

    Research output: Contribution to journalArticle

    122 Citations (Scopus)

    Abstract

    Between January 1980 and October 1983, 417 patients were randomized for mastectomy followed by axillary node sampling or full axillary clearance. The aim of the study was to determine whether a standard 'four-node' axillary sample, followed by careful dissection of removed tissue, could accurately indicate the extent of local treatment required. Axillary radiotherapy was given only to patients with histological involvement of sampled nodes and not to any having axillary clearance. The incidence of involved nodes was similar for both groups, as were distant relapse and survival rates. Currently 62.6 percent are alive after clearance and 65.0 percent after sampling. A non-significant increase in the rate of locoregional relapse was observed for those treated by axillary node clearance, this being due mainly to increased relapse on the unirradiated chest wall (clearance 21 percent versus sampling 12 percent in patients with node-positive disease). There was only a minor difference in axillary relapse, favouring axillary clearance (3.0 versus 5.4 percent). In patients with operable breast cancer, mastectomy with axillary node sampling gives equal control to mastectomy with axillary node clearance but, as morbidity is greater, surgical clearance of the axilla is the preferred option.
    Original languageEnglish
    Pages (from-to)1504-1508
    Number of pages5
    JournalBritish Journal of Surgery
    Volume82
    Issue number11
    DOIs
    Publication statusPublished - 1995

    Fingerprint

    Mastectomy
    Recurrence
    Axilla
    Thoracic Wall
    Dissection
    Radiotherapy
    Survival Rate
    Breast Neoplasms
    Morbidity
    Incidence
    Therapeutics

    Keywords

    • Adult
    • Aged
    • Breast Neoplasms
    • Carcinoma in Situ
    • Female
    • Humans
    • Lymph Node Excision
    • Mastectomy
    • Middle Aged
    • Neoplasm Recurrence, Local
    • Paget's Disease, Mammary
    • Radiotherapy, Adjuvant
    • Survival Rate
    • Treatment Outcome

    Cite this

    Forrest, A. P. M., Everington, D., McDonald, C. C., Steele, R. J., Chetty, U., & Stewart, H. J. (1995). The Edinburgh randomized trial of axillary sampling or clearance after mastectomy. British Journal of Surgery, 82(11), 1504-1508. https://doi.org/10.1002/bjs.1800821118
    Forrest, A. P. M. ; Everington, D ; McDonald, C. C. ; Steele, R. J. ; Chetty, U. ; Stewart, H. J. / The Edinburgh randomized trial of axillary sampling or clearance after mastectomy. In: British Journal of Surgery. 1995 ; Vol. 82, No. 11. pp. 1504-1508.
    @article{14fefc449d4e4e18aedd3ba2fea7520f,
    title = "The Edinburgh randomized trial of axillary sampling or clearance after mastectomy",
    abstract = "Between January 1980 and October 1983, 417 patients were randomized for mastectomy followed by axillary node sampling or full axillary clearance. The aim of the study was to determine whether a standard 'four-node' axillary sample, followed by careful dissection of removed tissue, could accurately indicate the extent of local treatment required. Axillary radiotherapy was given only to patients with histological involvement of sampled nodes and not to any having axillary clearance. The incidence of involved nodes was similar for both groups, as were distant relapse and survival rates. Currently 62.6 percent are alive after clearance and 65.0 percent after sampling. A non-significant increase in the rate of locoregional relapse was observed for those treated by axillary node clearance, this being due mainly to increased relapse on the unirradiated chest wall (clearance 21 percent versus sampling 12 percent in patients with node-positive disease). There was only a minor difference in axillary relapse, favouring axillary clearance (3.0 versus 5.4 percent). In patients with operable breast cancer, mastectomy with axillary node sampling gives equal control to mastectomy with axillary node clearance but, as morbidity is greater, surgical clearance of the axilla is the preferred option.",
    keywords = "Adult, Aged, Breast Neoplasms, Carcinoma in Situ, Female, Humans, Lymph Node Excision, Mastectomy, Middle Aged, Neoplasm Recurrence, Local, Paget's Disease, Mammary, Radiotherapy, Adjuvant, Survival Rate, Treatment Outcome",
    author = "Forrest, {A. P. M.} and D Everington and McDonald, {C. C.} and Steele, {R. J.} and U. Chetty and Stewart, {H. J.}",
    year = "1995",
    doi = "10.1002/bjs.1800821118",
    language = "English",
    volume = "82",
    pages = "1504--1508",
    journal = "British Journal of Surgery",
    issn = "0007-1323",
    publisher = "Wiley",
    number = "11",

    }

    Forrest, APM, Everington, D, McDonald, CC, Steele, RJ, Chetty, U & Stewart, HJ 1995, 'The Edinburgh randomized trial of axillary sampling or clearance after mastectomy', British Journal of Surgery, vol. 82, no. 11, pp. 1504-1508. https://doi.org/10.1002/bjs.1800821118

    The Edinburgh randomized trial of axillary sampling or clearance after mastectomy. / Forrest, A. P. M.; Everington, D; McDonald, C. C.; Steele, R. J.; Chetty, U.; Stewart, H. J.

    In: British Journal of Surgery, Vol. 82, No. 11, 1995, p. 1504-1508.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - The Edinburgh randomized trial of axillary sampling or clearance after mastectomy

    AU - Forrest, A. P. M.

    AU - Everington, D

    AU - McDonald, C. C.

    AU - Steele, R. J.

    AU - Chetty, U.

    AU - Stewart, H. J.

    PY - 1995

    Y1 - 1995

    N2 - Between January 1980 and October 1983, 417 patients were randomized for mastectomy followed by axillary node sampling or full axillary clearance. The aim of the study was to determine whether a standard 'four-node' axillary sample, followed by careful dissection of removed tissue, could accurately indicate the extent of local treatment required. Axillary radiotherapy was given only to patients with histological involvement of sampled nodes and not to any having axillary clearance. The incidence of involved nodes was similar for both groups, as were distant relapse and survival rates. Currently 62.6 percent are alive after clearance and 65.0 percent after sampling. A non-significant increase in the rate of locoregional relapse was observed for those treated by axillary node clearance, this being due mainly to increased relapse on the unirradiated chest wall (clearance 21 percent versus sampling 12 percent in patients with node-positive disease). There was only a minor difference in axillary relapse, favouring axillary clearance (3.0 versus 5.4 percent). In patients with operable breast cancer, mastectomy with axillary node sampling gives equal control to mastectomy with axillary node clearance but, as morbidity is greater, surgical clearance of the axilla is the preferred option.

    AB - Between January 1980 and October 1983, 417 patients were randomized for mastectomy followed by axillary node sampling or full axillary clearance. The aim of the study was to determine whether a standard 'four-node' axillary sample, followed by careful dissection of removed tissue, could accurately indicate the extent of local treatment required. Axillary radiotherapy was given only to patients with histological involvement of sampled nodes and not to any having axillary clearance. The incidence of involved nodes was similar for both groups, as were distant relapse and survival rates. Currently 62.6 percent are alive after clearance and 65.0 percent after sampling. A non-significant increase in the rate of locoregional relapse was observed for those treated by axillary node clearance, this being due mainly to increased relapse on the unirradiated chest wall (clearance 21 percent versus sampling 12 percent in patients with node-positive disease). There was only a minor difference in axillary relapse, favouring axillary clearance (3.0 versus 5.4 percent). In patients with operable breast cancer, mastectomy with axillary node sampling gives equal control to mastectomy with axillary node clearance but, as morbidity is greater, surgical clearance of the axilla is the preferred option.

    KW - Adult

    KW - Aged

    KW - Breast Neoplasms

    KW - Carcinoma in Situ

    KW - Female

    KW - Humans

    KW - Lymph Node Excision

    KW - Mastectomy

    KW - Middle Aged

    KW - Neoplasm Recurrence, Local

    KW - Paget's Disease, Mammary

    KW - Radiotherapy, Adjuvant

    KW - Survival Rate

    KW - Treatment Outcome

    U2 - 10.1002/bjs.1800821118

    DO - 10.1002/bjs.1800821118

    M3 - Article

    VL - 82

    SP - 1504

    EP - 1508

    JO - British Journal of Surgery

    JF - British Journal of Surgery

    SN - 0007-1323

    IS - 11

    ER -