Is it time to relook the management of axilla in post-neoadjuvant breast cancer cases in a re-evolving era of current axillary management?-Reference-Cited by-同舟云学术

Is it time to relook the management of axilla in post-neoadjuvant breast cancer cases in a re-evolving era of current axillary management?

Published:2017-02 Issue:1 Volume:6 Page:23-29
ISSN:1758-1923
Container-title:Breast Cancer Management
language:en
Short-container-title:Breast Cancer Management

Author:

Mirza Shaukat Mahmood¹,Ali Liaqat¹,Rajinder Dhaliwal¹,Asad Maria¹,Aitken Jane²

Affiliation:

1. Department of Breast Surgery, Hinchingbrooke Hospital, NHS Trust, Huntingdon, Cambridgeshire PE29 6NT, UK

2. Department of Breast Surgery, West Suffolk Hospital, NHS Foundation Trust, Bury St Edmunds, Suffolk IP33 2QZ, UK

Abstract

Aim: Axillary node dissection (AND) is an established practice, recently a conservative approach to axilla has resurged but there is reluctance to pass this benefit to neoadjuvant chemotherapy (NAC) cases, even in complete responders. Present study aims to look whether this approach is applicable to post-NAC cases. Patients & methods: Prospective study of 100 cases of NAC for breast cancer. Results: The core positive axillary nodes at diagnosis (66) after NAC had AND, 25 (38%) showed pathological complete response (pCR) in axillary nodes and 41 (62%) have residual disease. While, 34 with radiologically normal nodes, incidence of positive sentinel lymph node biopsy after NAC is lower as compared with patients without NAC. Conclusion: We conclude that it is time to re-examine axillary management in post-NAC cases with pCR, and possibly avoiding AND in 30–40% cases. Also, there is no place for upfront sentinel lymph node biopsy which offers no gain.

Publisher

Future Medicine Ltd

Subject

Radiology Nuclear Medicine and imaging,Oncology

Link

https://www.futuremedicine.com/doi/pdf/10.2217/bmt-2017-0003

Reference52 articles.

1. Long-term Outcome of Patients Managed With Sentinel Lymph Node Biopsy Alone for Node-Negative Invasive Breast Cancer

2. Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

3. Sentinel Lymph Node Biopsy in Breast Cancer

4. Post-operative arm morbidity and quality of life. Results of the ALMANAC randomised trial comparing sentinel node biopsy with standard axillary treatment in the management of patients with early breast cancer

5. Axillary Dissection vs No Axillary Dissection in Women With Invasive Breast Cancer and Sentinel Node Metastasis