Management of Axilla in 2015 in Indian Scenario

Sentinel lymph node biopsy is now increasingly being considered the favored method to treat low volume axilla. Most often this is followed by adjuvant radiation directed at axilla. In India however, sentinel node itself is still not widely practiced. The radiotherapy facilities are also not uniform, with cobalt units still being used in many centers. The long-term complications related to radiation are not assessed well. In fact there are also questions whether the evidence from early screen detected cancers in western population can be blindly followed in our population with a possibly different tumor biology and presentation as locally advanced being the norm. However, it is possible that we will see lesser axillary surgery in the minimal axillary disease group, in the not so distant future. We will look at the emerging evidence with an open mind and try to look at how this is applicable to our scenario.