Published in:
01-12-2018 | ASO Author Reflections
ASO Author Reflections: Moving Forward De-escalation of Axillary Surgery After Neoadjuvant Treatment in Breast Cancer
Author:
Isabel T. Rubio, MD, PhD
Published in:
Annals of Surgical Oncology
|
Special Issue 3/2018
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Excerpt
The use of neoadjuvant treatments (NATs) has increased in recent years. The development of new drugs in the neoadjuvant setting and the consideration of pathologic complete response (pCR) as an endpoint in most of these clinical trials has brought surgical management to the frontline, mainly regarding the axilla. With increasing rates of pCR in the axilla, those patients with biopsy-proven axillary nodes who are excellent responders may be spared an axillary node dissection. Marking the positive axilla at the time of diagnosis has reduced false negative rates of sentinel lymph node (SLN) in this setting;
1 however, the best method to mark the positive node is still under investigation. The use of intraoperative breast ultrasound (IOUS) in the neoadjuvant setting has been refined to accurately excise ultrasound-visible markers.
2 The aim of our study was to assess the feasibility of IOUS-guided excision of the clipped node during sentinel lymph node biopsy (SLNB) and to investigate whether the accuracy of SLNB is improved.
3 …
