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Axillary Node Management in Patients Receiving Neoadjuvant Chemotherapy

  • Local-Regional Evaluation and Therapy (KK Hunt, Section Editor)
  • Published:
Current Breast Cancer Reports Aims and scope Submit manuscript

Abstract

Neoadjuvant chemotherapy (NAC) has increasingly been used to allow breast conservation, without compromising survival or local control. NAC can also downstage nodal status in about 40 % of women with positive nodes (cN+). Concurrently, primary surgical management of the axilla has transitioned towards sentinel lymph node biopsy (SLNB) as the preferred alternative to axillary lymph node dissection (ALND) for clinically node-negative patients. Although some still support SLNB prior to NAC for node-negative breast cancer, the use of SLNB after NAC has become an increasingly accepted practice. SLNB after NAC for node-positive breast cancer has remained more controversial. Recent trials show that the false-negative rates for SLNB after NAC for women presenting with positive nodes are approximately 10 % when two tracers are used for mapping and two or more SLNs are examined. This review summarizes the available evidence and rationale regarding management of regional nodes in women receiving NAC.

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Conflict of Interest

Leopoldo J Fernandez declares that he has no conflict of interest.

Harry D Bear has received grants and personal fees from Genomic Health Inc., outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Surgical Oncology, Virginia Commonwealth University and Massey Cancer Center, West Hospital 7-422, 1200 East Broad Street, PO Box 980011, Richmond, VA, 23298, USA

    Leopoldo J. Fernandez & Harry D. Bear

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  1. Leopoldo J. Fernandez
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  2. Harry D. Bear
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Correspondence to Harry D. Bear.

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This article is part of the Topical Collection on Local-Regional Evaluation and Therapy

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Fernandez, L.J., Bear, H.D. Axillary Node Management in Patients Receiving Neoadjuvant Chemotherapy. Curr Breast Cancer Rep 7, 30–36 (2015). https://doi.org/10.1007/s12609-014-0168-6

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  • DOI: https://doi.org/10.1007/s12609-014-0168-6

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