[Positive sentinel node in breast cancer - when and why also opt for axillary dissection?]

One of the central concerns of contemporary mammary surgery is to verify the actual need for axillary dissection (AD) in patients with early breast cancer and positive sentinel lymph node biopsy. Several studies have addressed this issue (ASOCOG Z0011, IBCSG 23-01, MIRROR, EORTC AMAROS). So far, the preliminary results of the ASOCOG Z0011 trial with a median follow-up of 6.3 years and the results of the IBCSG 23-01 trial with a median follow-up of 5 years have been published. The conclusions of both randomized studies have implied that under specific circumstances, there is no significant difference in the local or regional recurrence between patients who had undergone completion AD compared to the patients in whom AD had been omitted. This article summarizes the current knowledge regarding indications for AD in patients with positive sentinel nodes. Key words: breast cancer - sentinel lymph node biopsy - axillary lymph node dissection - ACOSOG Z0011 trial.