TUESDAY, March 31, 2026 (HealthDay News) -- For patients with breast cancer with limited nodal disease after neoadjuvant therapy, axillary radiotherapy (ART) is as effective as axillary lymphadenectomy (ALND), with fewer cases of lymphedema, according to two studies presented at the annual European Breast Cancer Conference, held from March 25 to 27 in Barcelona, Spain.
Amparo Garcia-Tejedor, M.D., Ph.D., from the Bellvitge University Hospital in Barcelona, Spain, and colleagues examined whether ART without lymphadenectomy can safely replace ALND in patients with limited nodal disease after neoadjuvant therapy in a phase 3 multicenter trial involving patients with cT1 to T4b, cN0 to cN1 breast cancer and one to two positive sentinel lymph nodes. Participants were randomly assigned to ART or ALND (46 and 56, respectively). The researchers observed no axillary recurrences in the ART arm and one (1.8 percent) in the ALND arm. Distant metastases occurred in 4.4 and 5.5 percent, respectively, and there were two deaths in the ALND arm. Comparable two-year disease-free and overall survival rates were seen.
Maria Laplana-Torres, M.D., from the Hospital Clinic of Barcelona in Spain, and colleagues examined the toxicity and quality-of-life profiles of ART versus ALND in the same trial. The researchers found that the mean total RT dose was significantly higher in the ART group versus the ALND group. Acute grade ≥2 skin toxicity occurred in 27.8 and 13.3 percent of patients undergoing ART and ALND, respectively; there were no significant differences in late skin toxicity. The incidence of lymphedema was numerically -- but not statistically significantly -- lower with ART (18.9 versus 26.7 percent). Comparable long-term quality-of-life outcomes were seen between the study arms.
"These results show that axillary radiotherapy may be a safe and less invasive option for some women treated with chemotherapy or hormone therapy before surgery," Laplana-Torres said in a statement.