Lymph nodal radiotherapy in breast cancer: what are the unresolved issues?

被引：4

作者：

Fozza, Alessandra ^{[1
]}

Giaj-Levra, Niccolo ^{[2
]}

De Rose, Fiorenza ^{[3
]}

Ippolito, Edy ^{[4
]}

Silipigni, Sonia ^{[4
]}

Meduri, Bruno ^{[5
]}

Fiorentino, Alba ^{[6
]}

Gregucci, Fabiana ^{[6
]}

Marino, Lorenza ^{[7
]}

Di Grazia, Alfio ^{[7
]}

Cucciarelli, Francesca ^{[8
]}

Borghesi, Simona ^{[9
]}

De Santis, Maria Carmen ^{[10
]}

Ciabattoni, Antonella ^{[11
]}

机构：

[1] IRCCS Policlin San Martino, Dept Radiat Oncol, Largo Rosanna Benzi 10, I-16132 Genoa, GE, Italy

[2] IRCCS Sacro Cuore Don Calabria Hosp, Adv Radiat Oncol Dept, Negrar Di Valpolicella, Italy

[3] Santa Chiara Hosp, Radiat Oncol, Trento, Italy

[4] Campus Biomed Univ Rome, Radiat Oncol, Rome, Italy

[5] Univ Hosp Modena, Radiat Oncol Dept, Modena, Italy

[6] Gen Reg Hosp F Miulli, Radiat Oncol Dept, Acquaviva Delle Fonti, Italy

[7] REM, Radiotherapy Oncol Dept, Catania, Italy

[8] Osped Riuniti Umberto 1, Radiotherapy Inst, Dept Internal Med, Ancona, Italy

[9] S Donato Hosp, Unit Radiat Oncol, Arezzo, Italy

[10] Fdn IRCCS Inst Nazl Tumori, Radiotherapy Unit 1, Milan, Italy

[11] Presidio Osped San Filippo Neri, UOC Radioterapia, Rome, Italy

来源：

EXPERT REVIEW OF ANTICANCER THERAPY | 2021年 / 21卷 / 08期

关键词：

Breast cancer; radiotherapy; sentinel lymph node biopsy; axillary dissection; neoadjuvant chemotherapy; LOCOREGIONAL RADIATION-THERAPY; DEGRO PRACTICAL GUIDELINES; NEOADJUVANT CHEMOTHERAPY; AXILLARY SURGERY; FOLLOW-UP; SENTINEL; BIOPSY; RISK; METAANALYSIS; IRRADIATION;

D O I：

10.1080/14737140.2021.1917390

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: Sentinel lymph node biopsy (SLNB) is the gold standard in invasive breast cancer. Axillary dissection (ALND) is controversial in some presentations. Areas covered: Key questions were formulated and explored focused on four different scenarios in adjuvant axillary radiation management in early and locally advanced breast cancer. Answers to these questions were searched in MEDLINE, PubMed from June 1946 to August 2020. Clinical trials, retrospective studies, international guidelines, meta-analysis, and reviews were explored. Expert opinion: Analysis according to biological disease characteristics is necessary to establish the impact of ALND avoidance in unexpectedly positive SLNB (pN1) in cN0 patients. A low-risk probability of axillary recurrence was observed if axillary radiotherapy (ART) or ALND were offered without impact on outcomes. Adjuvant RNI in pT1-3 pN1 treated with mastectomy or BCS should be proposed in unfavorable disease and risk factors. In ycN0 after NACT, SLNB can be offered in selected cases or ALND should be performed. After SLNB post-NACT (ypN1), ALND and adjuvant radiotherapy are mandatory.

引用

页码：827 / 840

页数：14

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