RECENT MANAGEMENT OF AXILLARY LYMPH NODE METASTASIS IN PATIENTS WITH BREAST CANCER

Abstract

Treatment of early breast cancer involves surgery to remove the tumor (a lumpectomy or mastectomy) and management of the axilla. The axilla is examined to assess the stage of the tumor whether it has spread from breast to surrounding nodes in order to determine further treatment options and prognosis. The status of the axillary lymph nodes is one of the most important prognostic factors in women with early stage cancer. Traditionally, the standard surgical method of axilla assessment has been removal of lymph nodes (axillary dissection) for examination by a pathologist. However, axillary dissection is associated with clinically significant morbidity, particularly lymphoedema. Sentinel node biopsy (a less invasive surgical procedure) to assess the axilla in women with tumours three centimetres or less in diameter and clinically negative nodes. For patients with early stage breast cancer who are clinically node negative, we recommend initial axillary evaluation with SLND rather than ALND (Grade 1B).