Patient views on axillary therapy after positive sentinel node biopsy
Research type
Research Study
Full title
Mixed methods study into the views of women regarding further axillary treatment options following a positive sentinel node biopsy for breast cancer.
IRAS ID
365363
Contact name
lynda wyld
Contact email
Sponsor organisation
Doncaster and Bassetlaw Teaching Hospitals NHS Trust
Duration of Study in the UK
0 years, 6 months, 31 days
Research summary
Women with breast cancer may develop cancer in the lymph glands under their arms. Traditionally treatment has involved surgical removal of all of the 20 or so glands underneath the arm, alongside removal of the breast lump from the breast. This is called an axillary node clearance (ANC) and is a major operation with a high rate of complications. One such complication is long term arm swelling (lymphoedema). Recent clinical trials have shown that their is no survival advantage to having an ANC, even if the glands are involved. Modern practice is for women to have only a couple of glands removed in a sentinel node biopsy (SLNB) and only perform an ANC if the glands contain cancer. Even more recent trials have shown that in a large percentage of women, excellent results are achieved by giving radiotherapy to the remaining axillary nodes rather than surgically removing them. This leads to lower rates of lymphoedema and better quality of life.
In the UK treatment of the axilla is very variable. Some units still perform ANC for all women, some give radiotherapy and some a mix of the two options. One of the reasons for this variable practice is that UK NICE guidelines recommend that women are offered a choice of ANC or radiotherapy. This is a very complex decision, and many surgeons have biases towards one or other option, so in many cases patients struggle with this choice.
This research plans to interview women who have been offered a choice of treatment for their axillary glands, whether they felt well prepared to make this choice, whether they needed more information and what this information should be. We will also develop a questionnaire survey to be used with the same group of women to pilot it, before deploying it more widely.REC name
South West - Central Bristol Research Ethics Committee
REC reference
26/SW/0003
Date of REC Opinion
8 Jan 2026
REC opinion
Further Information Favourable Opinion