In a study published in the Annals of surgical oncology journal, further axillary lymph node dissection (ALND) failed to improve the outcome in patients with early #breast_cancer and 1-2 positive sentinel lymph node (SLN). The SINODAR-ONE trial is a prospective noninferiority multicenter phase III study that randomized 899 patients with T1-2 breast cancer who had BCS or mastectomy and SLN and found to have 1 or 2 pathologically positive nodes to either ALND or no further surgery.

After a median follow up of 34 months, there were 26 recurrences (11 in ALND arm versus 15 in the SNL only arm ,p = 0.444). In addition, there was only 1 axillary recurrence in each arm. These results are in line with several other studies among them, the ACOSOG Z-11 study.