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Management of the Clinically Node-Negative Axilla in Primary Breast Cancer

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Personalized Treatment of Breast Cancer

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Abstract

Axillary lymph node status is an important prognostic factor in patients with primary breast cancer. Yet, management of the axilla in these patients has been controversial. Sentinel lymph node biopsy (SLNB) is a less morbid procedure with similar survival and recurrence when compared to axillary lymph node dissection (ALND) and has emerged as the standard of care for staging patients with clinically node-negative disease. The results of three randomized trials seem to suggest that completion ALND may not be necessary in all women with T1/T2 tumors that have sentinel node-positive tumors and a low burden of axillary disease. However, while patients with isolated tumor cells or micrometastatic disease in the sentinel node may forego further axillary treatment, we believe that those with macrometastatic disease on SLNB should undergo additional axillary treatment (either ALND or radiotherapy) until further evidence defining which patients may benefit from observation alone emerges.

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  1. Division of Surgical Oncology and Endocrine Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA

    Abdul Q. Alarhayem & Ismail Jatoi

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  1. Abdul Q. Alarhayem
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  2. Ismail Jatoi
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Correspondence to Ismail Jatoi .

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Editors and Affiliations

  1. Department of Breast Surgery Graduate Sc, Kyoto University, Kyoto, Kyoto, Japan

    Masakazu Toi

  2. Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA

    Eric Winer

  3. Addenbrooke’s Hospital, Cambridge University Hospitals, Cambridge, Cambridgeshire, United Kingdom

    John Benson

  4. University of Arkansas for Medical Scien, Little Rock, Arkansas, USA

    Suzanne Klimberg

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Alarhayem, A.Q., Jatoi, I. (2016). Management of the Clinically Node-Negative Axilla in Primary Breast Cancer. In: Toi, M., Winer, E., Benson, J., Klimberg, S. (eds) Personalized Treatment of Breast Cancer. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55552-0_8

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