Axillary management after neoadjuvant treatment.

IF 1.3 Q3 Medicine Minerva chirurgica Pub Date : 2020-12-01 DOI:10.23736/S0026-4733.20.08600-9
Giacomo Montagna, Giovanni Corso, Rosa Di Micco, Nathalie Van Den Rul, Nicola Rocco
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引用次数: 1

Abstract

Since its introduction nearly 30 years ago, sentinel lymph node biopsy (SLNB) has become the standard technique to stage the axilla for the great majority of patients with early breast cancer. While the accuracy of SLNB in clinically node-negative patients who undergo neoadjuvant chemotherapy (NAC) is similar to the upfront surgery setting, modifications of the technique to improve the false negative rate are necessary in node-positive patients at presentation. Currently, patients who present with matted nodes, cN1 patients who fail to downstage to cN0 with NAC and those with pathological residual disease have an indication to undergo axillary lymph node dissection. Ongoing trials will confirm if extensive nodal irradiation can replace surgery in patients with residual nodal disease after NAC and if nodal radiotherapy can be omitted in patients who achieve nodal pathological complete response. The aim of this review was to focus on the open questions on the management of the axilla after NAC.

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新辅助治疗后腋窝管理。
自近30年前推出以来,前哨淋巴结活检(SLNB)已成为绝大多数早期乳腺癌患者腋窝分期的标准技术。虽然在接受新辅助化疗(NAC)的临床淋巴结阴性患者中,SLNB的准确性与术前设置相似,但在淋巴结阳性患者就诊时,修改技术以提高假阴性率是必要的。目前,出现结簇的患者,伴有NAC的cN1患者未能降期至cN0,以及病理性残留疾病的患者都有进行腋窝淋巴结清扫的指征。正在进行的试验将证实广泛的淋巴结放疗是否可以替代NAC后残留淋巴结疾病患者的手术,以及是否可以在达到淋巴结病理完全缓解的患者中省略淋巴结放疗。本综述的目的是关注NAC术后腋窝管理的开放性问题。
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来源期刊
Minerva chirurgica
Minerva chirurgica 医学-外科
CiteScore
1.40
自引率
0.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: Minerva Chirurgica publishes scientific papers on surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.
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