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Sentinel Node Lymph Node Surgery After Neoadjuvant Therapy: Principles and Techniques

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Surgical management of the axilla in breast cancer has been a topic of great interest. While sentinel lymph node biopsy (SLNB) is an established approach for patients undergoing surgical treatment as the first element of their care, there is continued debate regarding surgical management of the axilla in patients receiving neoadjuvant chemotherapy (NAC). In clinically node-negative patients, it has been debated whether or not SLNB should be performed before chemotherapy to accurately determine the clinical stage, or after chemotherapy, thus prioritizing the response to therapy and potentially minimizing axillary surgery. Node-positive patients have undergone axillary lymph node dissection in the past, however this paradigm has been challenged in recent years. Thus, surgeons must understand the importance of accurate axillary information both before and after NAC, and its role in multidisciplinary planning. We present a summary of the data surrounding axillary management in patients receiving NAC, and recommendations for surgical technique.

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Jennifer M. Racz MD, MBA

  2. Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Abigail S. Caudle MD, MS

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  1. Jennifer M. Racz MD, MBA
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Correspondence to Abigail S. Caudle MD, MS.

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Jennifer M. Racz has no conflicts of interest or disclosures to declare. Abigail S. Caudle is supported by a National Institutes of Health Cancer Center Support grant (CA16672) and has received travel expenses for speaking engagements from EndoMag. She is also the Principal Investigator for research supported by EndoMag.

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Racz, J.M., Caudle, A.S. Sentinel Node Lymph Node Surgery After Neoadjuvant Therapy: Principles and Techniques. Ann Surg Oncol 26, 3040–3045 (2019). https://doi.org/10.1245/s10434-019-07591-6

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  • DOI: https://doi.org/10.1245/s10434-019-07591-6

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