Axillary dissection is no longer indicated in patients with clinically node-negative axilla with 1-2 positive sentinel lymph nodes following upfront surgery or in patients with clinically node-negative axilla following neoadjuvant chemotherapy. Breast cancer has evolved away from routine axillary clearance to the less invasive sentinel lymph node biopsy to now complete omission of axillary sampling in select patients. We will review the most salient evidence that has shaped these practice changes over the last three decades. Current practice controversies are especially relevant for elderly populations and those receiving neoadjuvant therapy. Ongoing clinical trials will provide data to further guide breast cancer surgical management.
Keyphrases
- sentinel lymph node
- lymph node
- neoadjuvant chemotherapy
- clinical trial
- end stage renal disease
- primary care
- healthcare
- locally advanced
- ejection fraction
- early stage
- minimally invasive
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- clinical practice
- quality improvement
- stem cells
- prognostic factors
- machine learning
- ultrasound guided
- patient reported outcomes
- atrial fibrillation
- big data
- deep learning
- coronary artery bypass