Current Oncology Reports

, Volume 13, Issue 1, pp 5–10

The Need for Axillary Dissection in Patients with Positive Axillary Sentinel Lymph Nodes

Authors

  • Randal L. Croshaw
    • Department of Human OncologyDrexel University College of Medicine
    • Division of Breast Surgical OncologyAllegheny General Hospital
  • Kathleen M. Erb
    • Department of Human OncologyDrexel University College of Medicine
    • Division of Breast Surgical OncologyAllegheny General Hospital
  • Hilary M. Shapiro-Wright
    • SSM Healthcare—St. Clare Hospital
    • Department of Human OncologyDrexel University College of Medicine
    • Division of Breast Surgical OncologyAllegheny General Hospital
    • National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations Office
Article

DOI: 10.1007/s11912-010-0133-0

Cite this article as:
Croshaw, R.L., Erb, K.M., Shapiro-Wright, H.M. et al. Curr Oncol Rep (2011) 13: 5. doi:10.1007/s11912-010-0133-0

Abstract

The need for completion axillary dissection after a positive sentinel node biopsy continues to be challenged. In the 2 years since we last reviewed this subject, a number of authors have shared their experiences about micrometastatic disease and isolated tumor cells, opining both for and against axillary treatment. Data from the ACOSOG Z0011 trial and other small studies do not appear to support the use of completion axillary dissection even for macro-metastatic disease in patients with clinically node-negative (N0) disease. While existing guidelines still recommend axillary dissection for patients with clinically positive nodes, even when conversion to clinically negative disease following neoadjuvant chemotherapy has occurred, this concept is being questioned in ACOSOG Z1071 and in several other recent small trials. The surgical approach to the treatment of breast cancer continues to move away from the traditional Halstedian concept.

Keywords

Axillary dissectionSentinel lymph nodeMicrometastasesMicrometastasisIsolated tumor cellsCompletion axillary dissectionNeoadjuvantChemotherapy

Copyright information

© Springer Science+Business Media, LLC 2010