How do the results of INSEMA and SOUND impact the decision of omitting SLND in young women with breast cancer and offering adjuvant RT to patients who would otherwise be candidates for omission?  

Both trials required radiation so I would recommend it for a young woman not getting sentinel lymph node evaluation, and would lean toward whole breast irradiation. INSEMA required whole breast irradiation and SOUND allowed partial breast irradiation (10% of patients) but the majority of patients re...

Please see my comments on the 2024 San Antonio Breast Cancer Symposium in this forum in January 2025 for more information. In brief, both the SOUND trial and the INSEMA trial had very low axillary failure rates (about 1%) in patients with no evidence of axillary node involvement on ultrasound. ...