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Chapter-07 Current Status of Axillary Management in Breast Cancer

BOOK TITLE: Roshan Lall Gupta’s: Recent Advances in Surgery-13

Author
1. Gupta SK
2. Khanna AK
ISBN
9789350903827
DOI
10.5005/jp/books/11901_7
Edition
1/e
Publishing Year
2013
Pages
14
Author Affiliations
1. Delhi Pharmaceutical Sciences and Research University (DPSRU), New Delhi, India; All India Institute of Medical Sciences (AIIMS), New Delhi, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
2. Institute of Medical Sciences, Banaras Hindu University Varanasi (UP), India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, Emcure Pharmaceuticals Ltd, Pune, Maharashtra, India, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Chapter keywords

Abstract

Axillary staging continue to be an important role in current management of breast cancer. Although, axillary lymph node dissection (ALND) is beneficial for loco-regional control but associated complication has considerable impact on quality of life. Sentinel lymph node (SLN) is the first draining lymph node and its biopsy identify the metastases to that regional lymphatic basin. It spares the morbidity of ALND in truly node negative female. The intraoperative technique has certain limitation for the evaluation of sentinel lymph node, now molecular techniques supplement the formal histology for detection of nodal metastases. SLN biopsy is contraindicated in clinically palpable axillary node and at the same time imaging techniques like ultrasonography, MRI, PET/CT may also be used to identify axillary metastases. Axillary clearance is the preferred option following positive SLNB or in patients with clinically positive axilla. Axillary radiotherapy is compared to ALND for treating axillary nodal disease. Although, higher recurrence rate noted in irradiation group compared to ALND with no significant difference in overall survival. The management of axilla continue to evolve based on new evidence.

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