Axilla Management in Early-Stage Breast Cancer
Objective
Objective
This guideline recommends the best strategies for the management and the best timing and treatment (surgical and radio-therapeutic) of the axilla in early-stage breast cancer.
Axillary lymph node dissection (ALND) is associated with significant morbidity. Even a completion axillary lymph node dissection following a pathologically positive sentinel lymph node by needle biopsy did not confer benefits sufficient to justify the morbidity risk.
A disease-free survival (DFS) advantage from loco-regional nodal irradiation (LRNI) in certain patients has been demonstrated, as has LRNI over whole-breast irradiation (WBI).
A place for neoadjuvant chemotherapy (NAC) is also under current study.
This systematic review and clinical practice guideline uses high-quality current data to propose best practice principles for management of the axilla in breast cancer.
Management
...nagement...
.... Staging
...ents ≥70 years of age with clinically n...
...patients...
...ying Statements for Staging:The informatio...
...ther Axillary Treatment: SLN(-)...
Clinicians should NOT recommend ALND for women w...
...n some selected patients (e.g., patie...
...ements for Further Axillary Treatment: SLN(-)...
...her Axillary Treatment: SLN(+)...
...No Further Axillary Surgery Beyon...
...who received breast conserving surgery. ( EB , H...
...o had mastectomy as well as for those...
...y of the Axilla (LRNI) Compared with No LRNIIt...
...y to the Axilla Compared with Further Surg...
...Compared with No TreatmentIn patients with unila...
.... When NAC is Use...
...y Node-negative Patients...
...o are initially clinically node-negative...
...y Node-positive Patients...
...atients who were initially clinically and bio...
...were initially clinically and biopsy-proven...
Post-mastectomy patients who are node-positive on...
...mmend LRNI for the post-mastectomy no...
...ecommend LRNI after ALND for patients clinical...
...making processes should be put in pla...
...Before or After NACWe recommend ag...
...entifying Sentinel No...
...Single versus Dual TracerFor patients ha...
...S-guided Staging versus Standard Guide...
...ally node-negative patients with early-...
...clinically palpable (i.e., clinically...
...S-guided Staging versus Surgical StagingWe recomme...
Figure 1. Management of the Axilla in Early-Stage Breast Cancer
...Management of the Axilla in Early-Sta...