title: Participation in the RACS sentinel node biopsy versus axillary clearance trial.
abstract: BACKGROUND
  The Royal Australasian College of Surgeons (RACS) SNAC trial is a randomized controlled trial of sentinel node biopsy (SNB) versus axillary clearance (AC). It opened in May 2001 and is recruiting rapidly with good acceptance by consumers.
  
  
  METHODS
  A study of eligibility and treatment choices was conducted between November 2001 and September 2002 for women presenting with early breast cancer to 10 centres participating in the trial.
  
  
  RESULTS
  More than half of the 622 women (54%) were ineligible for trial entry because they had large (> 3 cm) or multicentric cancers. Participation was offered to 92% of eligible women and was taken up by 63%. The commonest reason for not participating was the desire to choose treatment rather than have it randomly allocated. Despite this there is a great acceptance of clinical trials because very few women (4% of those eligible) gave 'lack of interest in clinical trials' as the reason for non-participation. Few women who declined trial participation chose to have SNB alone (4.5% of those eligible).
  
  
  CONCLUSIONS
  Sentinel node biopsy may become the standard of care for managing small breast cancers, but a significant number of patients will still require or choose axillary dissection. Results from large randomized trials are needed to determine the relative benefits and harms of SNB compared with AC. Surgeons must carefully discuss options for management with their patients.
authors.affiliation: Wesley Medical Centre, Brisbane, Queensland, Australia. wetzigng@powerup.com.au
authors.forename: Neil R
authors.initials: NR
authors.lastname: Wetzig
authors.forename: P Grantley
authors.initials: PG
authors.lastname: Gill
authors.forename: Owen
authors.initials: O
authors.lastname: Ung
authors.forename: John
authors.initials: J
authors.lastname: Collins
authors.forename: James
authors.initials: J
authors.lastname: Kollias
authors.forename: David
authors.initials: D
authors.lastname: Gillett
authors.forename: Val
authors.initials: V
authors.lastname: Gebski
authors.forename: Caroline
authors.initials: C
authors.lastname: Greig
authors.forename: Adam
authors.initials: A
authors.lastname: Ray
authors.forename: Martin
authors.initials: M
authors.lastname: Stockler
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery; D002755:Choice Behavior; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008327:Mammography; D009367:Neoplasm Staging; D010358:Patient Participation; D018579:Patient Selection; D021701:Sentinel Lymph Node Biopsy