Current approach of the axilla in patients with early-stage breast cancer
The Lancet Aug 19, 2017
Mamounas EP et al. – In this article, the authors discussed the current approach of axilla in patients with early–stage breast cancer. The authors suggested that surgical approach of axilla in patients with early–stage breast cancer has undergone considerable evolution in the past 25 years. Axillary–lymph–node dissection for staging (gold standard) has been replaced by sentinel–lymph–node (SLN) biopsy for patients with clinically negative axilla. For selected patients with limited SLN involvement, morbidity can be reduced by omitting completion axillary–lymph–node dissection or replacing with axillary radiotherapy. The clinical interest of axillary staging following neoadjuvant chemotherapy is increasing. This approach may contribute to reducing morbidity and tailoring of future systemic and locoregional treatment decisions by response assessment. The procedure can be attempted to simplify further by new techniques for lymphatic mapping. Thus, considering the reducing influence of axillary nodal status on adjuvant therapy decision–making, studies are in progress to evaluate if SLN biopsy can be avoided completely in selected patients.
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