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Management of the Axilla After Neoadjuvant Therapy: Current Data and Controversies

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Abstract

Neoadjuvant chemotherapy (NAC) is the standard treatment for patients with locally advanced breast cancer or inoperable breast cancer and is administered with the intention of downstaging the tumor. Until recently, axillary staging for invasive breast cancer was performed by complete axillary lymph node dissection for all patients presenting with a breast cancer diagnosis. However, with the development of lymphatic mapping techniques, sentinel lymph node biopsy (SLNB) has become the accepted standard of care for axillary staging of breast cancers. It diminishes the potential morbidity of an axillary dissection, including paresthesias and lymphedema, but involves the risks of an operative procedure. Despite its use, there is tremendous debate about the use of SLNB in patients receiving neoadjuvant chemotherapy. Management of the axilla in the face of neoadjuvant chemotherapy is addressed in this article.

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Acknowledgments

The Fashion Footwear Charitable Foundation of New York, Inc.; Associates for Breast and Prostate Cancer Studies; The Avon Foundation; The Margie and Robert E. Petersen Foundation; Linda and Jim Lippman.

Compliance with Ethics Guidelines

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Conflict of Interest

Alexandra Gangi, Michael Choi, and Armando E. Giuliano, declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors. With regard to the authors’ research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Cedars-Sinai Medical Center, 310 N. San Vicente Blvd, 3rd floor, Los Angeles, CA, 90048, USA

    Alexandra Gangi, Michael Choi & Armando E. Giuliano

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  1. Alexandra Gangi
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  2. Michael Choi
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  3. Armando E. Giuliano
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Correspondence to Armando E. Giuliano.

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Gangi, A., Choi, M. & Giuliano, A.E. Management of the Axilla After Neoadjuvant Therapy: Current Data and Controversies. Curr Breast Cancer Rep 6, 283–288 (2014). https://doi.org/10.1007/s12609-014-0167-7

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  • DOI: https://doi.org/10.1007/s12609-014-0167-7

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