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Related Concept Videos

Assessing Body Temperature - Axilla01:14

Assessing Body Temperature - Axilla

588
Procedural Guide for Assessing Axillary Body Temperature using a Digital Thermometer:
Step 1: Perform hand hygiene and put on clean gloves to maintain infection control and prevent cross-contamination.
Step 2: Prepare the patient by explaining the procedure to ensure understanding and cooperation. Ensure privacy, expose the axilla, and inform the patient that minimal movement is crucial for an accurate reading.
Step 3: Adjust the patient’s clothing to expose only the axilla. It minimizes...
588

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Related Experiment Video

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Targeted axillary dissection: worldwide variations in clinical practice.

Michalis Kontos1, Prodromos Kanavidis2, Thorsten Kühn3

  • 1National and Kapodistrian University of Athens, Athens, Greece.

Breast Cancer Research and Treatment
|January 4, 2024
PubMed
Summary

Targeted axillary dissection (TAD) is increasingly used for breast cancer staging. Global surgeon practices vary regarding indications and limitations, influenced by tumor biology and lymph node status.

Keywords:
Axillary stagingBreast cancerPreoperative chemotherapySentinel node biopsyTargeted axillary dissectionTumour subtypes

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Targeted axillary dissection (TAD) is gaining traction for staging clinically node-positive (cN+) breast cancer patients who become node-negative after neoadjuvant chemotherapy (NAC).
  • TAD offers a lower false-negative rate and reduced arm morbidity compared to traditional methods.

Purpose of the Study:

  • To investigate global variations in clinical practice concerning indications for TAD.
  • To explore perceived limitations of TAD among breast surgeons worldwide.

Main Methods:

  • A global survey of surgeons was conducted using a structured 18-question questionnaire.
  • Responses were collected electronically from May 1st to August 1st, 2022.

Main Results:

  • 137 responses from 36 countries were analyzed.
  • 73.7% of surgeons consider TAD for cN+ patients receiving NAC, with indications varying by tumor size (T-stage) and number of positive nodes (median 3).
  • HER2-positive and Triple-Negative subtypes showed higher likelihoods for TAD (86% and 79.1%) compared to Luminal A/B subtypes.

Conclusions:

  • Significant global differences exist in the current practice of TAD for breast cancer axillary staging.
  • Tumor biology, including subtype and lymph node burden, critically influences the choice of axillary staging method.