Omission of axillary dissection after a positive sentinel lymph-node: Implications in the multidisciplinary treatment of operable breast cancer

Autor: Isabella Castellano, Fiorella Ruatta, Giulia Amato, Franziska Kubatzki, Anna Sapino, Elena Geuna, Filippo Montemurro, Riccardo Ponzone, Paola Sgandurra, Marco Gatti
Rok vydání: 2016
Předmět:
medicine.medical_specialty
medicine.medical_treatment
Sentinel lymph node
Context (language use)
Breast Neoplasms
Disease
law.invention
03 medical and health sciences
Breast cancer
Chemotherapy
Multidisciplinary breast team
Prognosis
Radiotherapy
Sentinel lymph-node biopsy
Oncology
Radiology
Nuclear Medicine and Imaging
0302 clinical medicine
Randomized controlled trial
law
Nuclear Medicine and Imaging
Biopsy
medicine
Breast-conserving surgery
Humans
Radiology
Nuclear Medicine and imaging
030212 general & internal medicine
Randomized Controlled Trials as Topic
medicine.diagnostic_test
business.industry
Sentinel Lymph Node Biopsy
General surgery
General Medicine
medicine.disease
Combined Modality Therapy
Surgery
Radiation therapy
030220 oncology & carcinogenesis
Lymphatic Metastasis
Lymph Node Excision
Female
Lymph Nodes
Radiology
business
Zdroj: Cancer treatment reviews. 48
ISSN: 1532-1967
Popis: Omission of axillary dissection in women with breast cancer and one or two positive sentinel-node biopsy is a major advancement in the management of this disease. Supported by a sound rationale and confirmed by prospective, randomized trials, omission of axillary dissection is now recommended in women who have undergone breast conserving surgery and who are candidate to adjuvant radiotherapy. Because breast cancer is best managed in the context of a multidisciplinary team, this surgical shift in the paradigm is expected to have implications that extend also to the other specialties involved in the team. In fact, the full evaluation of the axillary tumor burden has been historically considered an essential part of tumor staging and the absolute number of involved node critical information to tailor post-surgical treatments. Lack of this information in a patient with axillary involvement documented by a positive sentinel lymph-node biopsy may represent a challenge when deciding on further, post-surgical treatments. This review will address the critical aspects and the potential implications of omission of axillary dissection in the context of the multidisciplinary breast team.
Databáze: OpenAIRE
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