1108 / 1816
cN1 NAC ypN+
Alliance trial A011202
Comparison of ALND with axillary RT for pts with node-positive BC treated with
NAC
cT1-3N1M0
Needle biopsy proving nodal disease before NAC
NAC
Residual nodal disease after NAC (>0.2mm)
Randomisation
ALND + RNI (undissected axilla + level III, supraclav fossa+IMN I-III)
RNI (full axilla level I-III + supraclav fossa + IMN I-III
Primary endpoint: invasive breast cancer recurrence-free interval
Start 2014, expected closure 2024
Accrual 2918 pts
Notice:
In the retrospective MSKCC study the risk of 5-yr LRR in triple neg pts with
ypN+ was 26% (all had ALND + PMRT, however, clinical stages 2/3)
Target for RT after PST, ongoing trials