title: Assessing second echelon lymph nodes during sentinel lymph node biopsy: can we have more accurate axillary treatment for breast cancer patients?
abstract: Sentinel lymph node biopsy (SLNB) is the standard treatment for breast cancer patients with clinically negative axilla. For patients with positive sentinel lymph nodes, axillary lymph node dissection (ALND) was required. However, approximately a half of the SLNs-positive patients were found to have clear axillary lymph nodes after ALND, indicating that they had received unnecessary ALND without therapeutic benefit. Therefore, we propose a hypothesis for solution of this clinical problem. We defined the second echelon lymph nodes (SELNs) as those nodes receiving lymphatic drainage directly from the SLNs. For patients with positive-SLNs, SELNs can be biopsy and assessed. If SELNs are negative, no more ALND was needed in these patients even if their SLNs are positive. If our hypothesis were confirmed to be true, we can tailored our axillary treatment to more breast cancer patients, avoiding unnecessary ALND and its complications.
authors: Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, PR China.
authors: Kai
authors: K
authors: Chen
authors: Weijuan
authors: W
authors: Jia
authors: Nanyan
authors: N
authors: Rao
authors: Heran
authors: H
authors: Deng
authors: Liang
authors: L
authors: Jin
authors: Erwei
authors: E
authors: Song
authors: Fengxi
authors: F
authors: Su
mesh_terms: D001365:Axilla / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*