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Axillary lymph node management strategies in cN + breast cancer patients after neoadjuvant chemotherapy.
Clin Transl Oncol
December 2024
Breast Disease Center, Peking University First Hospital, Beijing, 100034, China.
With the widespread use of neoadjuvant chemotherapy (NAC), the optimal management strategy for axillary lymph nodes following chemotherapy has become a hot topic of discussion. For patients with clinically positive axillary lymph nodes (cN +) (defined as axillary lymph nodes confirmed positive by pathology before NAC), axillary lymph node dissection (ALND) remains the current standard treatment. However, there is still no consensus on whether sentinel lymph node biopsy (SLNB) and other local axillary treatments following NAC can safely replace ALND to reduce injury and complications.
View Article and Find Full Text PDFIs Axillary Lymph Node Dissection Needed? Clinicopathological Correlation in a Series of 224 Neoadjuvant Chemotherapy-Treated Node-Positive Breast Cancers.
Clin Breast Cancer
November 2024
Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, RI. Electronic address:
Article Synopsis
- * Out of 224 patients, 63 underwent ALND due to persistent positive lymph nodes, revealing that the number of positive sentinel lymph nodes is a key predictor of additional nodal involvement.
- * The results suggest that for patients with fewer than 2 positive sentinel lymph nodes after treatment, less invasive surgery (SLNB alone) may be a safe option, helping to inform surgical decisions for better locoregional control.
Combined analysis of the MF18-02/MF18-03 NEOSENTITURK studies: ypN-positive disease does not necessitate axillary lymph node dissection in patients with breast cancer with a good response to neoadjuvant chemotherapy as long as radiotherapy is provided.
Cancer
January 2025
Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Article Synopsis
- The study investigates the safety of omitting axillary lymph node dissection (ALND) in patients with residual axillary disease after neoadjuvant chemotherapy (NAC), focusing on those treated with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD).
- An analysis of two multicenter cohorts (MF18-02 and MF18-03) included 501 patients who received regional nodal irradiation and achieved a complete clinical response to NAC.
- Results showed low recurrence rates (0.4% axillary, 0.8% locoregional) and no significant differences in disease-free or disease-specific survival between SLNB and TAD, suggesting ALND omission is safe if patients receive
A systematic review of the complications of skin puncturing procedures in the upper limbs of patients that have undergone procedures on the axilla or breast.
Ann Transl Med
August 2024
Department of Plastic Surgery, Peninsula Health, Melbourne, Australia.
Background: The increasing incidence and prevalence of breast malignancies have led to increasing numbers of surgical interventions performed on the axilla and breast, including axillary lymph node dissection (ALND), sentinel lymph node biopsy (SLNB), and mastectomy. The risk of postoperative complications, like breast cancer-related lymphoedema (BCRL), can have significant deleterious cosmetic and quality of life effects. National guidelines and cancer councils publish recommendations to avoid skin puncturing procedures, such as venepuncture and intravenous (IV) cannulation, on arms ipsilateral to the surgical site to prevent BCRL occurrence.
View Article and Find Full Text PDFAxillary Surgery for Breast Cancer in 2024.
Cancers (Basel)
April 2024
Breast Surgery, University Hospital Basel, 4031 Basel, Switzerland.
Axillary surgery for patients with breast cancer (BC) in 2024 is becoming increasingly specific, moving away from the previous 'one size fits all' radical approach. The goal is to spare morbidity whilst maintaining oncologic safety. In the upfront surgery setting, a first landmark randomized controlled trial (RCT) on the omission of any surgical axillary staging in patients with unremarkable clinical examination and axillary ultrasound showed non-inferiority to sentinel lymph node (SLN) biopsy (SLNB).
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