A Gandhi1, C Coles2, A Makris3, E Provenzano4, A Goyal5, A J Maxwell6, J Doughty7. 1. NIHR Manchester Biomedical Research Centre, The Nightingale Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK. Electronic address: ashu.gandhi@mft.nhs.uk. 2. Addenbrooke's Oncology Centre, University of Cambridge, Cambridge, UK. 3. Mount Vernon Cancer Centre, Northwood, Middlesex, UK. 4. NIHR Cambridge Biomedical Research Centre, Cambridge Experimental Cancer Medicine Centre, Cambridge Breast Research Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. 5. Department of Surgery, Royal Derby Hospital, Derby, UK. 6. NIHR Manchester Biomedical Research Centre, The Nightingale Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK; Division of Informatics, Imaging & Data Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK. 7. Department of Surgery, Gartnavel General Hospital, Glasgow, UK.
Abstract
AIMS: These multidisciplinary guidelines aim to provide clinically helpful, evidence-based recommendations on the surgical management of the axilla in patients who have received neo-adjuvant chemotherapy for early breast cancer. MATERIALS & METHODS: Following a review of published evidence, a writing group representing all disciplines quorate within a breast cancer multidisciplinary meeting prepared the guidelines. KEY RECOMMENDATIONS: In patients presenting with clinically node negative axillae, sentinel node biopsy (SNB) may be performed prior to or on completion of neo-adjuvant chemotherapy (NACT). In patients presenting with clinically node positive axillae, SNB may be safely considered following completion of NACT. Four nodes should be removed with dual mapping. If evidence of complete pathological response of previous metastases is seen, axillary radiotherapy may be offered. If residual cancer (isolated tumour cells, micro- or macrometastes) is seen within the SNB, offer axillary node dissection.
AIMS: These multidisciplinary guidelines aim to provide clinically helpful, evidence-based recommendations on the surgical management of the axilla in patients who have received neo-adjuvant chemotherapy for early breast cancer. MATERIALS & METHODS: Following a review of published evidence, a writing group representing all disciplines quorate within a breast cancer multidisciplinary meeting prepared the guidelines. KEY RECOMMENDATIONS: In patients presenting with clinically node negative axillae, sentinel node biopsy (SNB) may be performed prior to or on completion of neo-adjuvant chemotherapy (NACT). In patients presenting with clinically node positive axillae, SNB may be safely considered following completion of NACT. Four nodes should be removed with dual mapping. If evidence of complete pathological response of previous metastases is seen, axillary radiotherapy may be offered. If residual cancer (isolated tumour cells, micro- or macrometastes) is seen within the SNB, offer axillary node dissection.
Authors: I Whitehead; G W Irwin; F Bannon; C E Coles; E Copson; R I Cutress; R V Dave; M D Gardiner; M Grayson; C Holcombe; S Irshad; C O'Brien; R L O'Connell; C Palmieri; A M Shaaban; N Sharma; J K Singh; S Potter; S A McIntosh Journal: BMC Cancer Date: 2021-01-22 Impact factor: 4.430
Authors: Georgios-Ioannis Verras; Levan Tchabashvili; Francesk Mulita; Ioanna Maria Grypari; Sofia Sourouni; Evangelia Panagodimou; Maria-Ioanna Argentou Journal: Breast Cancer (Dove Med Press) Date: 2022-03-12