Individualizing axillary management in breast cancer treatment

被引：0

作者：

Dang C. ^{[1
]}

Giuliano A.E. ^{[1
]}

机构：

[1] Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048

来源：

Current Breast Cancer Reports | 2013年 / 5卷 / 2期

关键词：

Axillary lymph node dissection; Biopsy; Breast cancer; DCIS; Ductal carcinoma in situ; Lymph node metastases; Neoadjuvant chemotherapy; Prophylactic mastectomy; Sentinel lymph node;

D O I：

10.1007/s12609-013-0108-x

中图分类号：

学科分类号：

摘要：

Management of the axilla in patients with breast cancer has evolved significantly in the last century. The status of the axillary lymph nodes continues to provide important prognostic information. However, in contrast to the beliefs of Halsted, we now understand that surgical clearance of the axilla is not critical to long-term survival. Indeed, tumor biology and occult systemic metastases determine long-term survival after breast cancer treatment. Randomized controlled trials have demonstrated the safety and efficacy of sentinel lymph node biopsy in patients with early breast cancer and without clinical evidence of axillary involvement. Management of the axilla should be tailored to the individual patient's clinical stage, patient and tumor characteristics, and treatment preferences. Special consideration should be given to the following situations: elderly patients, pregnancy, treatment of DCIS, prior axillary surgery, prophylactic mastectomy, inflammatory breast cancer, and neoadjuvant chemotherapy. Management of the axilla will continue to change as additional evidence from randomized controlled trials becomes available. © 2013 Springer Science+Business Media New York.

引用

页码：99 / 105

页数：6

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