Is it possible to avoid axillary dissection?

Česká verzia

Authors: J. Gatěk ¹ ; D. Vrána ²; B. Dudešek ¹; J. Duben ¹
Authors place of work: Chirurgické oddělení nemocnice Atlas Zlín, Univerzita Tomáše Bati ve Zlíně přednosta: doc. MUDr. J. Gatěk Ph. D. ¹; Onkologická klinika LF Univerzity Palackého v Olomouci přednosta: prof. MUDr. B. Melichar Ph. D. ²
Published in the journal: Rozhl. Chir., 2017, roč. 96, č. 8, s. 318-323.
Category: Review

Summary

The essential aim of oncology surgery including breast cancer is to remove the malignant tumour and lymph nodes. For many decades, dissection of axillary lymph nodes has been a common part of mastectomy, virtually the only surgical procedure in breast cancer treatment until the 90ies of the previous century. Although mastectomy has been replaced with breast preserving procedures, axillary dissection remained an integral part of the surgery. Sentinel lymph node biopsy (SLNB) has introduced a revolutionary change in breast cancer treatment in the axilla, replacing dissection in clinically negative axillary nodes. As a result, the number of radical procedures in the axilla was significantly limited, as well as the incidence of serious complications that may have a negative impact on the quality of life of the patients. As shown by other studies, the number of dissections can be reduced even further. Subsequent axillary dissection is unnecessary where the sentinel nodes contain only malignant cells, micrometastases and even a limited number of macrometastases. SLNB can also be used in a selected group of patients after neoadjuvant chemotherapy.

Key words:
breast carcinoma – axillary dissection – sentinel lymph node – micrometastases – macrometastases

Zdroje

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