RESUMO
La biopsia de ganglio centinela (GC) es la técnica de elección para el estudio de extensión de la axila en la mujer con cáncer de mama sin afectación ganglionar. Por el contrario, la linfadenectomía axilar (LA) constituye el procedimiento idóneo para las pacientes con afectación metastásica del GC. Durante los últimos años diferentes estudios han sugerido que algunas pacientes con afectación del GC pueden ser tratadas sin LA. Este artículo expone la revisión bibliográfica realizada por nuestro grupo multidisciplinar y su estrategia para la supresión de la LA en mujeres con afectación metastásica del GC. En esta nueva estrategia la LA no se llevaría a cabo en mujeres con tumores T1, con afectación de 1-2 GC e intervenidas mediante una técnica quirúrgica conservadora. Por el contrario, se indicaría la LA en aquellas pacientes con tres o más GC afectados, invasión extracapsular del GC, mujeres mastectomizadas y tumores del subtipo triple negativo o HER2+ que no reciban tratamiento biológico con anticuerpos (AU)
Sentinel lymph node (SLN) biopsy is the standard of practice for assessing axillary spread inclinically node-negative breast cancer patients. On the other hand, axillary lymph no dedissection (ALND) is the ideal procedure for patients with SLN metastasis. Different studies over the last few years have suggested that some patients with positive SLN can be treated without ALND. This article presents a literature review carried out by our multidisciplinary group and its strategy for avoiding routine ALND in women with SLN metastases. In this new strategy ALND should not be performed on women with T1 tumours, with 1-2 positive SLN and undergoing breast conservative surgery. On the other hand, ALND would be indicated in those patients with three or more positive SLN, presence of extracapsular invasion, mastectomised women and triple negative subtype or HER2+ tumours that have not received biological treatment with antibodies (AU)
Assuntos
Humanos , Feminino , Neoplasias da Mama/cirurgia , Metástase Linfática , /métodos , Biópsia de Linfonodo Sentinela , Recidiva Local de Neoplasia/patologia , Seleção de PacientesRESUMO
Sentinel lymph node (SLN) biopsy is the standard of practice for assessing axillary spread in clinically node-negative breast cancer patients. On the other hand, axillary lymph node dissection (ALND) is the ideal procedure for patients with SLN metastasis. Different studies over the last few years have suggested that some patients with positive SLN can be treated without ALND. This article presents a literature review carried out by our multidisciplinary group and its strategy for avoiding routine ALND in women with SLN metastases. In this new strategy ALND should not be performed on women with T1 tumours, with 1-2 positive SLN and undergoing breast conservative surgery. On the other hand, ALND would be indicated in those patients with three or more positive SLN, presence of extracapsular invasion, mastectomised women and triple negative subtype or HER2+ tumours that have not received biological treatment with antibodies.
