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Leveraging Neoadjuvant Chemotherapy to Minimize the Burden of Axillary Surgery: a Review of Current Strategies and Surgical Techniques

Leveraging Neoadjuvant Chemotherapy to Minimize the Burden of Axillary Surgery: a Review of... Purpose of ReviewAxillary nodal disease is significantly less likely in both clinically node-negative (cN0) and node-positive (cN+) breast cancer patients after neoadjuvant chemotherapy (NAC). There have thus been significant efforts to “de-escalate” axillary surgery in this setting. This review discusses modern axillary surgical paradigms and techniques after NAC.Recent FindingsIn cN0 patients, the accuracy and feasibility of sentinel lymph node biopsy (SLNB) after NAC is well-established, with prospective evidence supporting its oncologic safety. SLNB is also acceptable in select cN+ patients when certain criteria are met. There is mounting “real-world” evidence for the technical feasibility of this approach, including various methods of localizing and excising biopsy-proven nodes, with the ability to avoid axillary lymph node dissection in a substantial proportion of patients. However, outcome data is limited to small retrospective series.SummaryIn appropriately selected patients, there is increasing opportunity to leverage the benefits of NAC to minimize the burden of axillary surgery. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Breast Cancer Reports Springer Journals

Leveraging Neoadjuvant Chemotherapy to Minimize the Burden of Axillary Surgery: a Review of Current Strategies and Surgical Techniques

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Publisher
Springer Journals
Copyright
Copyright © Springer Science+Business Media, LLC, part of Springer Nature 2020
ISSN
1943-4588
eISSN
1943-4596
DOI
10.1007/s12609-020-00388-7
Publisher site
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Abstract

Purpose of ReviewAxillary nodal disease is significantly less likely in both clinically node-negative (cN0) and node-positive (cN+) breast cancer patients after neoadjuvant chemotherapy (NAC). There have thus been significant efforts to “de-escalate” axillary surgery in this setting. This review discusses modern axillary surgical paradigms and techniques after NAC.Recent FindingsIn cN0 patients, the accuracy and feasibility of sentinel lymph node biopsy (SLNB) after NAC is well-established, with prospective evidence supporting its oncologic safety. SLNB is also acceptable in select cN+ patients when certain criteria are met. There is mounting “real-world” evidence for the technical feasibility of this approach, including various methods of localizing and excising biopsy-proven nodes, with the ability to avoid axillary lymph node dissection in a substantial proportion of patients. However, outcome data is limited to small retrospective series.SummaryIn appropriately selected patients, there is increasing opportunity to leverage the benefits of NAC to minimize the burden of axillary surgery.

Journal

Current Breast Cancer Reports – Springer Journals

Published: Oct 24, 2020

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