Management of axillary lymph nodes in breast cancer in the era of precision medicine

doi:10.3877/cma.j.issn.1674-0807.2024.04.001

Abstract

Abstract:

The systemic treatment strategy for breast cancer is gradually changing, among which medical treatments such as endocrine therapy and targeted therapy are being enhanced, and breast surgery has entered the era of precision medicine, especially for the management of axillary lymph nodes. Traditional axillary lymph node dissection is gradually replaced by sentinel lymph node biopsy (SLNB). SLNB can significantly reduce unnecessary axillary dissection and the risk of postoperative complications such as lymphedema by accurately detecting axillary lymph node metastases, thereby improving the quality of life of patients after surgery. This article summarized the high-quality clinical studies on axillary lymph node management in recent years, confirmed the safety and efficacy of SLNB, and discussed differentiated treatment strategies for patients with sentinel lymph node micrometastases and macrometastases. In addition, this article analyzed the current status of axillary lymph node management after neoadjuvant chemotherapy and explored the potential for further exemption from SLNB through accurate assessment. The precision management of axillary lymph nodes is a remarkable advancement in breast cancer surgery, which can significantly reduce postoperative complications, and also provide strong evidences for individualized treatment of breast cancer.

Key words: Breast neoplasms, Precision medicine, Sentinel lymph node

Li Lin, Ying Yang, Yi Zhang. Management of axillary lymph nodes in breast cancer in the era of precision medicine[J]. Chinese Journal of Breast Disease(Electronic Edition), 2024, 18(04): 193-198.

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