[Proposal for a new multidisciplinary therapeutic strategy in the breast cancer patient with sentinel lymph node metastasis].
Sentinel lymph node (SLN) biopsy is the standard of practice for assessing axillary spread in clinically node-negative breast cancer patients. On the other hand, axillary lymph node dissection (ALND) is the ideal procedure for patients with SLN metastasis. Different studies over the last few years have suggested that some patients with positive SLN can be treated without ALND. This article presents a literature review carried out by our multidisciplinary group and its strategy for avoiding routine ALND in women with SLN metastases. In this new strategy ALND should not be performed on women with T1 tumours, with 1-2 positive SLN and undergoing breast conservative surgery. On the other hand, ALND would be indicated in those patients with three or more positive SLN, presence of extracapsular invasion, mastectomised women and triple negative subtype or HER2+ tumours that have not received biological treatment with antibodies.
Servicio de Cirugía General, Hospital Abente y Lago, Complexo Hospitalario Universitario, La Coruña, España. baceneb@sergas.es
Benigno
B
Acea
Lourdes
L
Calvo Martínez
Silvia
S
Antolín Novoa
Luis
L
Albaina Latorre
Manuel
M
Juaneda Magdalena
Paz
P
Santiago Freijanes
Carmen
C
Silva Rodríguez
Joaquín
J
Mosquera Osés
José R
JR
Varela Romero
Rafael
R
Soler Fernández
Isabel
I
Facio Villanueva
Isabel
I
Candal Casado
Carmen
C
Cereijo Garea
D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D010348:Patient Care Team; D021701:Sentinel Lymph Node Biopsy