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01-10-2020 | Breast Cancer | Breast Oncology

To Perform an Axillary Lymph Node Dissection or Not? That Is (Still) the Question

Author: Carla S. Fisher, MD, MBA, FACS

Published in: Annals of Surgical Oncology | Issue 10/2020

Excerpt

Management of the axilla is a topic very familiar, and perhaps frustrating, to surgeons treating breast cancer. Historically, the way we manage the axilla has been dictated by our view of the role it plays in breast cancer outcomes. …

Devitt JE. The influence of conservative and radical surgery on the survival of patients with breast cancer. Can Med Assoc J. 1962;87:906–10.PubMedPubMedCentral

Mamtani A, Barrio AV, Goldman DA, Wen HY, Vincent A, Morrow M. Extranodal tumor deposits in the axillary fat indicate the need for axillary dissection among T1–T2cN0 patients with positive sentinel nodes. Ann Surg Oncol. 2020. https://doi.org/10.1245/s10434-020-08632-1.CrossRefPubMed

Bonneau C, Hequet D, Estevez JP, Pouget N, Rouzier R. Impact of axillary dissection in women with invasive breast cancer who do not fit the Z0011 ACOSOG trial because of three or more metastatic sentinel lymph nodes. Eur J Surg Oncol. 2015;41:998–1004.CrossRef

Gooch J, King TA, Eaton A, et al. The extent of extracapsular extension may influence the need for axillary lymph node dissection in patients with T1–T2 breast cancer. Ann Surg Oncol. 2014;21:2897–903.CrossRef

Barrio AV, Downs-Canner S, Edelweiss M, et al. Microscopic extracapsular extension in sentinel lymph nodes does not mandate axillary dissection in Z0011-eligible patients. Ann Surg Oncol. 2020;27:1617–24.CrossRef

Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305:569–75.CrossRef

Giuliano AE, Ballman KV, McCall L, et al. Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (Alliance) randomized clinical trial. JAMA. 2017;318:918–26.CrossRef

National Comprehensive Cancer Network. 2020. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed 12 May 2020.

Johnson AR, Kimball S, Epstein S, et al. Lymphedema incidence after axillary lymph node dissection: quantifying the impact of radiation and the lymphatic microsurgical preventive healing approach. Ann Plast Surg. 2019;82(4S Suppl 3):S234–41.CrossRef

Title: To Perform an Axillary Lymph Node Dissection or Not? That Is (Still) the Question
Author: Carla S. Fisher, MD, MBA, FACS
Publication date: 01-10-2020
Publisher: Springer International Publishing
Keywords: Breast Cancer
Lymphedema
Breast Cancer
Published in: Annals of Surgical Oncology / Issue 10/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-020-08692-3

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To Perform an Axillary Lymph Node Dissection or Not? That Is (Still) the Question

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