Referring Physicians >> Newsletters >> June 2011 Breast Newsletter >> Modern Management of the Axilla in Breast Cancer
Modern Management of the Axilla in Breast Cancer
The decision possibilities encountered in the care of breast cancer patients are increasing exponentially. In the past year, multiple headlines and scientific articles have been published which have altered the care of the axilla in patients with breast malignancies.
Sentinel lymph node mapping has become the standard axillary surgery used for patients who present with Stage I and Stage II breast cancer. This procedure is performed in conjunction with the breast surgery (lumpectomy or mastectomy) or as a stand-alone operation to help determine the patient’s need for chemotherapy prior to surgery or eligibility for breast reconstruction procedures.
Sentinel lymph node operation steps:
For patients whose sentinel lymph nodes are negative by pathologic review, no additional axillary surgery is recommended.
For patients whose sentinel lymph nodes reveal metastatic disease, “how much, how many” becomes an important discussion to help decide if an axillary dissection should be performed to remove additional axillary nodes that may be positive for malignancy.
Current tools to assist with “how much, how many” include:
In addition, the patient should be considered for any available clinical trials that are applicable for his/her clinical tumor type and surgical pathology.
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