MINImal vs. MAXimal Invasive Axillary Staging and Treatment After Neoadjuvant Systemic Therapy in Node Positive Breast Cancer: Protocol of a Dutch Multicenter Registry Study (MINIMAX)

Abstract

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Patterns of care over 10 years in young breast cancer patients in the Netherlands, a nationwide population-based study

“…The most pronounced de-escalation trend in locoregional treatment we saw in our study was the impressive decline in the percentage of ALND's that we performed in both age groups and especially in young patients with cN1 treated with NST where ALND was only still performed in 29.7% patients during 2016 and 2020 whereas in the earlier years still in 67.0% of these patients an ALND was performed. This trend is also seen in other countries [ [35] , [36] , [37] ].…”

Diagnostic Accuracy of Radioactive Iodine Seed Placement in the Axilla With Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in Node-Positive Breast Cancer

“…Several randomized controlled trials are currently assessing these end points, both for patients with axillary pCR (Axillary Management in Breast Cancer Patients With Needle Biopsy–Proven Nodal Metastases After Neoadjuvant Chemotherapy [ATNEC]) and B51/RTOG1304 trials) and for patients with residual disease (Alliance 011202 and Tailored Axillary Surgery With or Without Axillary Lymph Node Dissection Followed by Radiotherapy in Patients With Clinically Node-Positive Breast Cancer [TAXIS] trials). In the Netherlands, a prospective registry for patients with cN+ breast cancer treated with NAC is currently recruiting patients (the Minimal vs Maximal Invasive Axillary Staging and Treatment After Neoadjuvant Systemic Therapy in Node-Positive Breast Cancer [MINIMAX] trial). With the heterogenous application of less and more invasive axillary management strategies in daily practice, this nationwide cohort allows for comparison between the different strategies in terms of survival as well as quality of life.…”

De-escalation of radiotherapy after primary chemotherapy in cT1–2N1 breast cancer (RAPCHEM; BOOG 2010–03): 5-year follow-up results of a Dutch, prospective, registry study

“…All have diseasefree survival as primary endpoint. In addition, MINIMAX (NCT04486495) 30 and AXSANA (NCT04373655) are registry studies that include both patients with axillary pathological complete response and those with residual disease. Together, these trials and registry studies will provide more information regarding appropriate loco regional treatment strategies for cN+ disease in terms of longterm prognosis and will help to create guidelines for patients in whom ALND is omitted.…”