AXILLARY LYMPHOADENECTOMY

Abstract

Axillary lymphoadenectomy re p resents one of the historical hallmarks in the surgical strategy for breast cancer treatment .

In recent years the role of axillary dissection is becoming mat ter for a re n e wed debate: up to date better therapeutic results together with new biologic acquisitions and pro g resses in earl y diagnosis have been influencing current indications and exten sion of axillary lymphoadenectomy; also, cosmetic and finan cial considerations play a re l e vant role. This is the back ground of a large number of studies investigating the possi bility of a more limited application of axillary dissection pro vided that oncologic results remain unchanged. In this con text sentinel node biopsy is one of the most promising lines of research. It can be stated that, as far as early stages are concerned, a trend tow a rds more conservative resection tech niques that started with the first quadrantectomies two deca des ago, is now involving axillary dissection too. Possibly, in the next future, an elective axillary lymphoadenectomy will not be perf o rmed any more if the presence of positive nodes will not be preliminarily ascertained. Ne ve rtheless such conse rvative strategy can not be recommended to date, until the technique of sentinel node biopsy will be optimized and its results confirmed by randomized trials.