The INSEMA Trial: Axillary Surgery in Breast Cancer & The SOUND Randomized Control Trial: Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer

Featured Articles

• Gentilini, O. D., Botteri, E., Sangalli, C., Galimberti, V., Porpiglia, M., Agresti, R., Luini, A., Viale, G., Cassano, E., Peradze, N., Toesca, A., Massari, G., Sacchini, V., Munzone, E., Leonardi, M. C., Cattadori, F., Di Micco, R., Esposito, E., Sgarella, A., Cattaneo, S., … SOUND Trial Group (2023). Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes: The SOUND Randomized Clinical Trial. JAMA oncology, 9(11), 1557–1564. https://doi.org/10.1001/jamaoncol.2023.3759

• Reimer, T., Stachs, A., Veselinovic, K., Kühn, T., Heil, J., Polata, S., Marmé, F., Müller, T., Hildebrandt, G., Krug, D., Ataseven, B., Reitsamer, R., Ruth, S., Denkert, C., Bekes, I., Zahm, D. M., Thill, M., Golatta, M., Holtschmidt, J., Knauer, M., … Gerber, B. (2025). Axillary Surgery in Breast Cancer – Primary Results of the INSEMA Trial. The New England journal of medicine, 392(11), 1051–1064. https://doi.org/10.1056/NEJMoa2412063

Reviewers

Methodological Reviewer: Sarah Knowles, MD, FRCSC, Western University

Clinical Reviewer: Stephanie Wong, MD, MPH, McGill University

Clinical Reviewer: Rebecca Warburton, MD, FRCSC, University of British Columbia

Featured Webinar

Questions

Please read the above article and consider the following questions:

1. What is the clinical question being addressed?
2. What is the study design? Is it appropriate?
3. What are the sources of data?
4. Are the data accurate and valid?
5. What was the intervention and how was it assessed?
6. What outcomes were considered?
7. Are there other clinically important outcomes that should be considered?
8. How large and precise was the difference in the outcome?
9. Are there any factors (confounders) that might explain the differences in the results?
10. State the conclusion. Have the authors addressed the clinical question posed?
11. Does the evidence support the conclusion?