[Preoperative Axillary Lymph Node Marking in Patients with Breast Cancer]

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Management

Background:

• Axillary dissection (AD) is standard for breast cancer staging but can cause long-term complications like lymphedema.
• Reducing the extent of axillary surgery is a focus, particularly for metastatic infiltration of axillary lymph nodes.
• Accurate clinical staging and lymph node marking are crucial for treatment decisions.

Purpose of the Study:

• To evaluate replacing AD with radiotherapy for positive sentinel lymph node (SLN) biopsy in clinically negative staging.
• To assess omitting AD and using SLN biopsy after neoadjuvant chemotherapy for clinically positive staging.
• To explore marking axillary lymph nodes suspected of infiltration.

Main Methods:

• Clinical trials were conducted to test three different approaches to axillary staging and treatment.
• Focus on sentinel lymph node (SLN) biopsy and its role in guiding axillary dissection decisions.
• Implementation of lymph node marking techniques for improved accuracy.

Main Results:

• Avoiding AD is oncologically safe for patients with positive SLN biopsy and negative clinical staging.
• Lymph node marking reduces false negativity of SLN biopsies after neoadjuvant chemotherapy in clinically positive staging.
• These methods aid in precisely identifying patients achieving complete pathological remission.

Conclusions:

• Axillary dissection can be safely omitted in specific breast cancer patient groups.
• Lymph node marking enhances the accuracy of staging after neoadjuvant chemotherapy.
• Optimized axillary staging strategies improve patient selection for treatment and reduce surgical morbidity.