TAXIS

TAXIS

Targeted axillary dissection (TAD) is a new technique that has recently been developed for patients with initially positive nodes undergoing systemic treatment before surgery. It combines the selective removal of nodes that are localized under imaging guidance.

The main objective of this trial is to show that TAD is non-inferior to conventional axillary lymph node dissection (ALND) in terms of disease-free survival of breast cancer patients

Lay Abstract

Worldwide more than 450’000 patients are diagnosed with breast cancer every year. It accounts for one-third of all cancer diagnoses among women and causes more than 130’000 deaths per year. Until the mid-nineties, the complete removal of all lymph nodes in the armpit was the standard treatment for patients with breast cancer, causing massive morbidity in one-third of patients with decreased quality of life. Over the past 25 years, this radical operation was slowly abandoned in patients without tumor signs in their lymph nodes. However, it is still standard of care in patients with cancer detected in their lymph nodes before surgery. 
This study addresses the questions if radical surgery of the lymph nodes can be safely replaced by a novel limited surgery concept called “tailored axillary surgery” in combination with radiotherapy, and if this new treatment combination results in better quality of life compared to the standard radical procedure. One half of the 1500 patients will undergo radical surgery and the other half will receive the new combination treatment. 
If this study is positive, it is likely to establish a new worldwide treatment standard with less side effects and better quality of life, while maintaining the same efficacy as radical surgery. This would help to decrease surgical overtreatment of patients with breast cancer on a global scale.