Current Management of the Axilla

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Axillary lymph node status is a critical factor in breast cancer surgical planning and treatment strategy.
• Despite advances in prognosis and predicting therapy response, axillary staging remains essential.
• The past two decades have seen significant, practice-changing advancements in axillary management.

Purpose of the Study:

• To review current best practices in axillary management for breast cancer patients.
• To focus on the evolving role of axillary management in the context of neoadjuvant systemic therapy.
• To provide an overview of recent evidence-based changes in surgical planning related to the axilla.

Main Methods:

• Review of multi-institutional randomized clinical trials.
• Synthesis of current evidence and clinical guidelines.
• Analysis of trends in axillary management over the last 20 years.

Main Results:

• Significant practice-changing advances have occurred in axillary management.
• Current best practices address both node-negative and node-positive patients.
• Neoadjuvant systemic therapy is increasingly influencing axillary management decisions.

Conclusions:

• Axillary management has evolved considerably, driven by robust clinical trial data.
• Best practices now incorporate strategies for patients receiving neoadjuvant therapy.
• Continued evaluation of axillary status remains fundamental for optimal breast cancer care.