Breast cancer can spread to lymph nodes under the arm (“axillary nodes”). Surgeons remove and examine the first lymph nodes to which cancer cells might spread (sentinel nodes) to determine the extent of cancer spread and to guide treatment. Removing many lymph nodes can sometimes cause a problem called lymphedema, in which fluid collects in the soft tissue of the affected arm, which can be uncomfortable. Surgeons therefore try to remove as few lymph nodes as possible while still providing the most effective care to treat a patient’s cancer.
In this study, researchers want to see if axillary radiation therapy is as effective as the standard treatment of removing the axillary nodes in patients who received chemotherapy before breast cancer surgery but who still have cancer cells in their sentinel nodes afterward. Patients with positive sentinel nodes after such “neoadjuvant” chemotherapy will be randomly assigned to one of two groups.
One group will have the standard treatment of having more axillary lymph nodes removed at the time of breast cancer surgery. The second group will have the investigational treatment, which is radiation therapy to the axillary lymph nodes without having more lymph nodes removed at the time of breast cancer surgery. Researchers will compare the two groups to see how well they do over a five-year period.