ASO Author Reflections: How Predictive Models Can Help Guide Axillary Surgery Decision Making After Neoadjuvant Chemotherapy

Excerpt

Breast cancer management is evolving continuously and tumor biology is clearly an important consideration for systemic therapy and prognosis, as reflected in its incorporation into the 8th edition of the American Joint Committee on Cancer staging system. Regarding advanced breast cancer, especially disease with lymphatic spread to the axilla, neoadjuvant chemotherapy (NAC) is increasingly being used.1 Prior to the American College of Surgeons Oncology Group (ACOSOG) Z1071 trial, patients with positive axillary lymph nodes were treated with axillary lymph node dissection (ALND), but now clinical trials have shown that sentinel lymph node (SLN) surgery is acceptable after NAC in appropriately selected patients.2 Our goal as surgeons is to perform the appropriate surgery for each patient and often requires individualization of care based on details of each specific case. Clinical tools and nomograms can be one way to assist in surgical decision making. …