Axillary Dissection Faces “De-escalation” Again: SENOMAC Study Confirms Non-inferior Survival Benefit of Exempting ALND for SLN Macrometastases
In the field of surgical treatment for breast cancer, the trend of "de-escalation" in axillary management has become a consensus. Although studies such as ACOSOG Z011 and AMAROS have laid the foundation for exempting axillary lymph node dissection (ALND) in patients with positive sentinel lymph nodes (SLN), controversy remains in clinical practice regarding whether it is safe to exempt ALND for patients undergoing total mastectomy, patients with large tumors (T3), and those with macrometastases. At this conference, Professor Jana de Boniface from Karolinska Institutet and Capio St. Göran Hospital in Sweden presented the highly anticipated latest results of the SENOMAC trial, a randomized controlled study focusing on survival data and patient-reported arm complications after exempting ALND in patients with SLN macrometastases.








