Related Experiment Video
Updated: Jun 26, 2025
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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
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Axillary Management: How Much Is Too Much?
Nicci Owusu-Brackett1, Benjin Facer2, Dionisia Quiroga3
1Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA.
Current Oncology Reports
|May 15, 2024
Summary
Axillary dissection is increasingly omitted in breast cancer management. Current evidence supports avoiding it in select patients with limited positive lymph nodes or after neoadjuvant chemotherapy, favoring less invasive methods.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Management
Background:
- Breast cancer treatment has evolved significantly over the past three decades.
- Routine axillary clearance is being replaced by less invasive surgical techniques.
Purpose of the Study:
- To review the current management of the axilla in breast cancer.
- To examine the evidence shaping recent changes in axillary staging practices.
Main Methods:
- Review of salient evidence over the last three decades.
- Analysis of current practice controversies and ongoing clinical trials.
Main Results:
- Axillary dissection is no longer indicated for patients with clinically node-negative axilla and 1-2 positive sentinel lymph nodes post-surgery.
- Omission of axillary sampling is now feasible for select patients, including those with clinically node-negative axilla post-neoadjuvant chemotherapy.
Conclusions:
- Breast cancer axillary management has shifted from routine dissection to selective omission.
- Current controversies exist, particularly for elderly patients and those receiving neoadjuvant therapy, with ongoing trials to further refine guidelines.
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