Articles

Practical guidelines in axillary management after neo-adjuvant chemotherapy in breast cancer patients

BJMO - , issue ,

K. Van Baelen , N. Van den Rul , S. Marquette , L. Vansteelant , J. Mebis MD, PhD, C. Thywissen , A.-S. Vliegen , L. NoƩ , M. Drijkoningen , G. Orye

SUMMARY

In clinical practice, the diversity in the surgical management of the axilla after neo-adjuvant chemotherapy (NACT) for node positive patients is huge. Given the morbidity of axillary lymph node dissection (ALND), a trend to perform a less invasive technique is seen in both literature and clinical practice. There are three major techniques: 1) sentinel lymph node biopsy (SLNB), 2) guided removal of lymph nodes that were positive prior to NACT, and 3) Targeted Axillary Dissection (TAD) which is a combination of the previous two techniques. Criteria for patients eligible for these techniques vary widely and oncological safety cannot always be guaranteed. With this report, we aim to introduce TAD in a safe way into the clinical practice.

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