关键词: 早期乳腺癌, 腋窝淋巴结, 前哨淋巴结活检

Abstract:

Research hotspots in axillary treatment for early-stage breast cancer        WANG Mao-li,WU Ke-jin. Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
Corresponding author: WU Ke-jin, E-mail: kejinwu@163.com
Abstract    Sentinel lymph node biopsy(SLNB) has replaced axillary lymph node dissection(ALND) to stage clinically node-negative breast cancer patients. In the patients with low-volume nodal metastasis, ALND could be safely avoided when treated with breast-conserving therapy eligible for Z0011 or IBCSG 23-01, or radiation considered referring to AMAROS. ALND is still recommended for patients with involved axillary nodes received mastectomy and not planned for radiation. Addition of regional nodal irradiation in subgroups of patients reduces locoregional recurrence significantly and should be recommended taken all clinical and pathologic factors considered for individual patients. For patients with clinically node-negative disease, SLNB following neoadjuvant therapy is considered an acceptable approach. Ultrasound-guided biopsy and localization of suspicious axillary lymph nodes before neoadjuvant therapy are preferred. SLNB may be an option after neoadjuvant therapy in patients with proven positive axillary nodes who achieved clinical complete response, given that usage double tracers, biopsy more than 2 sentinel lymph nodes, evaluation the labelled lymph node before neoadjuvant therapy, and stage N0 (i+) may be regarded as the criteria for ALND. ALND remains the standard-of-care for the subset of patients in clinical practice, unless enrolled on some clinical trials. Staying the current of axillary treatments in early-stage breast cancer helps to make wiser clinical decision and organize further in-depth research, so that safe, effective and moderate axillary treatments can be performed.

Key words: early-stage breast cancer, axillary lymph node, sentinel lymph node biopsy