Targeting and limiting surgery for patients with node-positive breast cancer

BMC Medicine

Review

Abigail S. Caudle¹  Henry M. Kuerer¹ 

[1] Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit1484, 77230-1402, Houston, TX, USA;

关键词: Axillary lymphadenectomy;    Breast cancer;    Neoadjuvant chemotherapy;    Nodal metastasis;    Sentinel lymph node;    Targeted axillary dissection;   

DOI  :  10.1186/s12916-015-0385-5

 received in 2015-04-14, accepted in 2015-06-03,  发布年份 2015

来源: Springer

【 摘 要 】

The presence of axillary nodal metastases has a significant impact on locoregional and systemic treatment decisions. Historically, all node-positive patients underwent complete axillary lymph node dissection; however, this paradigm has changed over the last 10 years. The use of sentinel lymph node dissection has expanded from its initial role as a surgical staging procedure in clinically node-negative patients. Clinically node-negative patients with small volume disease found on sentinel lymph node dissection now commonly avoid more extensive axillary surgery. There is interest in expanding this role to node-positive patients who receive neoadjuvant chemotherapy as a way to restage the axilla in hopes of sparing women who convert to node-negative status from the morbidity of complete nodal clearance. While sentinel lymph node dissection alone may not accomplish this goal, there are novel techniques, such as targeted axillary dissection, that may now allow for reliable nodal staging after chemotherapy.

【 授权许可】

CC BY   
© Caudle and Kuerer. 2015