Related Experiment Video
Updated: Jan 27, 2026
05:52
Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
13.1K
Axillary management still needed for patients with sentinel node micrometastases
Bin-Bin Cong1,2,3,4, Jin-Ming Yu3,4, Yong-Sheng Wang2,4
1School of Medicine and Life Sciences, University of Jinan and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Cancer Management and Research
|March 19, 2019
Summary
Axillary management in breast cancer is evolving. Omitting axillary lymph node dissection (ALND) is safe for select patients, but axillary recurrence requires careful consideration and further research for optimal treatment strategies.
Area of Science:
- Oncology
- Surgical Oncology
- Radiotherapy
Background:
- Clinical practice for axillary management in breast cancer has evolved due to randomized controlled trials.
- The American College of Surgeons Oncology Group Z0011 and IBCSG 23-01 trials support omitting axillary lymph node dissection (ALND) in select sentinel lymph node (SLN)-positive patients undergoing breast-conserving surgery (BCS).
Purpose of the Study:
- To evaluate the impact of omitting axillary lymph node dissection (ALND) on axillary recurrence rates in breast cancer patients.
- To explore effective strategies for controlling residual tumor burden in the axilla when ALND is omitted.
- To determine the role of radiotherapy and systemic therapy in managing SLN-positive patients without ALND.
Main Methods:
- Review of evidence from landmark trials like Z0011, IBCSG 23-01, OTOASOR, AMAROS, and POSNOC.
- Analysis of axillary recurrence rates in patients with and without axillary management.
- Evaluation of the role of whole breast irradiation (WBI) and regional nodal irradiation.
Main Results:
- Omitting ALND in SLN-positive patients receiving BCS and adjuvant therapy resulted in acceptable low axillary recurrence rates in some studies.
- However, patients without any axillary management showed significantly higher axillary recurrence rates compared to those with axillary management.
- Whole breast irradiation (WBI) after BCS and axillary regional nodal irradiation demonstrated control of regional residual tumor burden when ALND was omitted.
Conclusions:
- While omitting ALND is feasible for carefully selected SLN-positive patients, axillary recurrence rates must be considered.
- Whole breast irradiation (WBI) and regional nodal irradiation are effective in controlling axillary disease when ALND is omitted.
- Further research, including prediction models, is needed to identify patients who can safely avoid axillary management, but it remains recommended for SLN micrometastases currently.
More Related Videos
07:51The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
21.3K
06:37Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Published on: October 20, 2010
23.8K
Related Concept Videos
01:14Node Analysis for AC Circuits
671
Consider an angioplasty system featuring a catheter equipped with a turbine, a critical tool for removing plaque deposits from coronary arteries. This intricate medical device operates using a circuit model reminiscent of a dual-node RLC circuit powered by a current-controlled voltage source.
To unravel the complexities of this system, nodal analysis is employed, a powerful technique founded on Kirchhoff's current law (KCL), which remains valid for phasors. AC circuits can effectively be...
To unravel the complexities of this system, nodal analysis is employed, a powerful technique founded on Kirchhoff's current law (KCL), which remains valid for phasors. AC circuits can effectively be...
671
01:23Detailed Structure and Function of Lymph Nodes
4.6K
Lymph nodes are bean-shaped structures that cluster along the lymphatic vessels in the inguinal, axillary, and cervical regions. Each node is divided into compartments by a capsule that extends trabeculae inward.
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
4.6K
01:29Impression Management Techniques I: Managing Appearances
213
Appearance is a multidimensional aspect of self-presentation that encompasses observable attributes such as clothing, grooming, speech, and nonverbal behavior. These elements are often strategically managed to align with socially constructed expectations in different settings. For instance, individuals tailor their appearance during job interviews, social gatherings, or athletic events to meet the perceived norms of those environments.Contextual Adaptation and Social SignalsThe research...
213
01:26Tonsillitis II: Management
423
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
423
01:19Management of Insomnia
609
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
609
01:19Managing Impressions
168
Impression management encompasses individuals' deliberate efforts to shape how others perceive them during social interactions. This behavior is often employed to conform to social norms, secure approval, or pursue specific goals. While it involves selective self-presentation, it is not necessarily deceptive; individuals frequently present authentic aspects of themselves that align with situational demands.Common strategies include:Ingratiation: where individuals use flattery or agreeableness...
168