Atnec trial

ATNEC: Axillary management in T1-3N1M0 breast cancer patients with needle biopsy proven nodal metastases at presentation after neoadjuvant chemotherapy.

Overview

ATNEC is a phase III, open, randomised, multicentre trial comparing standard axillary treatment (either, axillary lymph node dissection [ALND] or axillary radiotherapy [ART]) with no axillary treatment post-surgery, in early stage (T1-3N1M0) breast cancer patients.

Currently, the presence of axillary lymph node metastases on needle biopsy, prior to neoadjuvant chemotherapy (NACT), is the determinant for whether a patient requires further axillary treatment (ALND or ART) post-surgery.

Axillary treatment damages lymphatic drainage from the arm and can cause life-long side effects such as lymphoedema, restricted shoulder movement or discomfort, pain, sensory changes and numbness. These adverse events interfere with daily activities, impair quality of life and are costly to the NHS in terms of rehabilitative treatments.

As more effective NACT is now available, that results in complete eradication of cancer in the axilla in 40% to 70% of patients, extensive axillary treatment may no longer be necessary in patients with no evidence of residual nodal disease. The ATNEC study aims to address this question.

Objectives

Primary objective:

To assess whether, omitting further axillary treatment (ALND and ART) for patients with early stage breast cancer and axillary nodal metastases on needle biopsy, who after NACT have no residual cancer in the lymph nodes on sentinel node biopsy, is non-inferior to axillary treatment in terms of disease free survival (DFS) and results in reduced risk of lymphoedema at 5 years.  

If this is works for BC it is going to stop invasive unnecessary surgery for a lot of people.     kind regards 

Have you taken part in the trial? I'm looking for people who have feedback, as I understand if the nodes removed still have remains of cancer then there will still need to be a full removal. Also wondering how people have got on in the future is it going to give me a higher chance of the cancer reoccurring 

No sorry i took part in chemo trial but this trial is very interesting.  kind regards

Literally cant find a single thing online of another person with experience of it just wanted to hear some feedback really, thanks for your reply x