[The surgical management of axillary lymph node disease in breast cancer patients].
Zhonghua Wai Ke Za Zhi
; 62(8): 731-736, 2024 Aug 01.
Article
em Zh
| MEDLINE
| ID: mdl-38937123
ABSTRACT
The precise assessment and management of the axillary lymph nodes in breast cancer is crucial for regional control, disease staging, selection of adjuvant chemotherapy strategies, and prediction of prognosis, with a general downward trend in surgical management. For early breast cancer with negative axillary lymph node metastases, sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) as the criterion for axillary status measurement. Patients can be exempted from ALND if they have negative SLNB results. However, it remains to be carefully decided in China whether patients with one or two positive nodes in SLNB can be spared from ALND. However, consensus has been met that patients who meet the criteria of the Z0011 study can be exempted from ALND. For breast cancer patients with positive axillary lymph nodes metastases at the beginning of treatment, the clearance of lymph node disease can be achieved by neoadjuvant therapy, with a reduced rate of complications related to ALND. In particular, there are still many debates associated with SLNB after neoadjuvant therapy, such as whether patients who remain axillary lymph node positive can be spared from ALND. Exploratory and validation studies related to the SLNB avoidance criteria are still controversial. In the future, clinicians should consider the characteristics of patients, the risk of recurrence, and adjuvant treatment regimens to develop individualized axillary lymph node management.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Axila
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Neoplasias da Mama
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Biópsia de Linfonodo Sentinela
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Excisão de Linfonodo
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Linfonodos
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Metástase Linfática
Limite:
Female
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Humans
Idioma:
Zh
Ano de publicação:
2024
Tipo de documento:
Article