Oncology Central

Management of axillary staging in breast cancer patients treated with neoadjuvant chemotherapy


Sentinel lymph node (SLN) biopsy is standard care for patients with cN0 breast cancer, and SLN-negative patients do not require axillary dissection (ALND). It is now clear that many patients with positive SLN do not require ALND. In ACOSOG Z0011, 6-year locoregional control and survival (in cT1–2N0 patients with ≤2 positive SLN treated by breast conservation and whole breast radiotherapy) were comparable for SLN biopsy alone compared to SLN biopsy plus ALND. A growing body of data now suggests that ALND may not be required for selected patients outside the Z0011 eligibility criteria, including those treated with neoadjuvant chemotherapy (NAC).

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