The proper management of the axilla in all patients with breast cancer has been an
area of active investigation. Although involvement of the axillary nodes remains an
important prognostic factor, the approach to gathering this information has changed
dramatically. Axillary lymph node dissection (ALND), long a standard component of
the management of early stage breast cancer, remains the standard approach only for
patients with clinically palpable axillary nodes or many positive axillary nodes confirmed
by sampling techniques. For women with early stage breast cancer with a clinically
negative axilla, ALND is no longer a routine part of the surgical treatment of breast
cancer, having been replaced with the less invasive sentinel lymph node biopsy (SLNB).
1
,
2
In patients with clinically node negative breast cancer, SLNB identifies patients
without axillary node involvement, sparing them the morbidity of ALND.
[3]
Several studies have shown that SLNB is associated with lower rates of arm morbidity,
including lymphedema, sensory loss, and range of motion deficits when compared to
a standard ALND.
4
,
- Lucci A.
- McCall L.M.
- Beitsch P.D.
- Whitworth P.W.
- Reintgen D.S.
- Blumencranz P.W.
- et al.
Surgical complications associated with sentinel lymph node dissection (SLND) plus
axillary lymph node dissection compared with SLND alone in the American College of
Surgeons Oncology Group Trial Z0011.
J Clin Oncol. 2007; 25: 3657-3663
5
,
6
,
- Fleissig A.
- Fallowfield L.J.
- Langridge C.I.
- Johnson L.
- Newcombe R.G.
- Dixon J..M.
- et al.
Post-operative arm morbidity and quality of life. Results of the ALMANAC randomized
trial comparing sentinel node biopsy with standard axillary treatment in the management
of patients with early breast cancer.
Breast Cancer Res Treat. 2006; 95: 279-293
7
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Article info
Publication history
Published online: May 11, 2012
Accepted:
April 4,
2012
Received:
April 3,
2012
See accompanying article on page X. (Editorial will accompany article by Cluze et al. “Inequality in sentinal lymph node dissection for elderly women with early stage breast cancer: Results from a French prospective cohort study")Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
