Axillary nodal management following neoadjuvant chemotherapy: A review Journal Article


Authors: Pilewskie, M.; Morrow, M.
Article Title: Axillary nodal management following neoadjuvant chemotherapy: A review
Abstract: Importance: The increasing use of neoadjuvant chemotherapy (NAC) for operable breast cancer has raised questions about optimal local therapy for the axilla. Observations: Sentinel lymph node biopsy (SLNB) after NAC in patients presenting with clinically negative nodes has an accuracy similar to upfront SLNB and reduces the need for axillary lymph node dissection compared with SLNB prior to NAC. In patients presenting with node-positive disease, clinical trials demonstrate that SLNB after NAC is accurate when 3 or more sentinel nodes are obtained, but long-term outcomes are lacking. The relative importance of pre- and post-NAC stage in predicting risk of locoregional recurrence remains an area of controversy. Conclusions and Relevance: Neoadjuvant chemotherapy reduces the need for axillary lymph node dissection, and SLNB is an accurate method of determining nodal status after NAC.
Keywords: chemotherapy, adjuvant; neoadjuvant therapy; lymphatic metastasis; sentinel lymph node biopsy; pathology; breast neoplasms; adjuvant chemotherapy; axilla; humans; human; female
Journal Title: JAMA Oncology
Volume: 3
Issue: 4
ISSN: 2374-2437
Publisher: American Medical Association  
Date Published: 2017-04-01
Start Page: 549
End Page: 555
Language: English
DOI: 10.1001/jamaoncol.2016.4163
PUBMED: 27918753
PROVIDER: scopus
PMCID: PMC5580251
DOI/URL:
Notes: Review -- Export Date: 2 June 2017 -- Source: Scopus
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  1. Monica Morrow
    772 Morrow
  2. Melissa Louise Pilewskie
    112 Pilewskie