Paper of the Month - April, 2012

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Can we avoid axillary dissection in the micrometastatic sentinel node in breast cancer?

Galimberti V, Botteri E, Chifu C et al.
Sentinel lymph node biopsy (SLNB) is the standard approach for a clinically uninvolved axilla in breast cancer, as it has been shown to accurately stage the axilla yet is a minimally invasive surgical approach and allows axillary lymph node dissection (ALND) to be omitted when the sentinel lymph node is negative. Nevertheless, there is considerable interest in foregoing ALND even when the SLN is positive, particularly when the involvement is minimal (micrometastases or isolated tumor cells [ITCs]). In the present retrospective study, the authors aimed to assess the effect of no ALND on axillary recurrence, first events, and overall survival (OS) in a consecutive series of patients with a minimally involved SLN (micrometastases or ITCs) who, for various reasons, did not receive ALND or any other axillary treatment after SLNB.


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