期刊
CURRENT ONCOLOGY REPORTS
卷 13, 期 1, 页码 5-10出版社
SPRINGER
DOI: 10.1007/s11912-010-0133-0
关键词
Axillary dissection; Sentinel lymph node; Micrometastases; Micrometastasis; Isolated tumor cells; Completion axillary dissection; Neoadjuvant; Chemotherapy
类别
资金
- National Cancer Institute, National Institutes of Health, and Department of Health and Human Services [U10-CA-37377, U10-CA-69974, U10-CA-12027, U10-CA-69651]
- Pittsburgh Affiliate of Susan G. Komen for the Cure
The need for completion axillary dissection after a positive sentinel node biopsy continues to be challenged. In the 2 years since we last reviewed this subject, a number of authors have shared their experiences about micrometastatic disease and isolated tumor cells, opining both for and against axillary treatment. Data from the ACOSOG Z0011 trial and other small studies do not appear to support the use of completion axillary dissection even for macrometastatic disease in patients with clinically node-negative (N0) disease. While existing guidelines still recommend axillary dissection for patients with clinically positive nodes, even when conversion to clinically negative disease following neoadjuvant chemotherapy has occurred, this concept is being questioned in ACOSOG Z1071 and in several other recent small trials. The surgical approach to the treatment of breast cancer continues to move away from the traditional Halstedian concept.
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