Current Breast Cancer Reports

, Volume 5, Issue 2, pp 99–105

Individualizing Axillary Management in Breast Cancer Treatment

Local-Regional Evaluation and Therapy (KK Hunt, Section Editor)


Management of the axilla in patients with breast cancer has evolved significantly in the last century. The status of the axillary lymph nodes continues to provide important prognostic information. However, in contrast to the beliefs of Halsted, we now understand that surgical clearance of the axilla is not critical to long-term survival. Indeed, tumor biology and occult systemic metastases determine long-term survival after breast cancer treatment. Randomized controlled trials have demonstrated the safety and efficacy of sentinel lymph node biopsy in patients with early breast cancer and without clinical evidence of axillary involvement. Management of the axilla should be tailored to the individual patient’s clinical stage, patient and tumor characteristics, and treatment preferences. Special consideration should be given to the following situations: elderly patients, pregnancy, treatment of DCIS, prior axillary surgery, prophylactic mastectomy, inflammatory breast cancer, and neoadjuvant chemotherapy. Management of the axilla will continue to change as additional evidence from randomized controlled trials becomes available.


Breast cancer Sentinel lymph node Axillary lymph node dissection Lymph node metastases Biopsy Ductal carcinoma in situ DCIS Prophylactic mastectomy Neoadjuvant chemotherapy 


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of Surgical Oncology, Department of SurgeryCedars-Sinai Medical CenterLos AngelesUSA

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