SNAC 2 Trial

The status of the axillary or armpit lymph nodes remains the most important indicator of outcome for women with breast cancer and helps predict the need for further treatment (e.g. chemo or radiotherapy).  Traditionally, axillary node status has been determined by removal of most of the nodes (axillary clearance or dissection).   This operation may lead to arm swelling (lymphoedema), pain, some abnormal skin sensation or shoulder stiffness.

Recent studies show that removal of one or more "sentinel nodes" (sentinel node biopsy or removal of the first lymph nodes related to a breast cancer may provide reliable information on axillary node status - at least for women with small breast cancers.  This might avoid axillary clearance in many woman but this depends on accurately finding and removing the sentinel nodes.  By minimising the amount of surgery to the armpit it is known that the side effects of axillary surgery will be reduced.

The initial SNAC Part 1 trial (now closed to accrual) aimed to answer the question, "does sentinel node biopsy result inr educed side effects from surgery compared to the standard surgery of axillary clearance?".  Part 2 of this research extends the work started in Part 1.  This extension eavluates the use of sentinel node boipsy in women with larger breast cancers or with more than one cancer in the breast.  Part 2 of the SNAC Trial will contribute to answering the very important question, "does sentinel node boipsy result in increased local recurrence or decreased survival, and if so, for which group of women is this the case and for whom is axillary clearance really necessary?".