Sentinel node biopsy in conservative surgery for breast cancer: a changing role in clinical practice.

IF 1.3 Q3 Medicine
Minerva chirurgica Pub Date : 2020-12-01 Epub Date: 2020-09-25 DOI:10.23736/S0026-4733.20.08481-3
Francesca Magnoni, Paolo Veronesi
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引用次数: 1

Abstract

Recent studies have demonstrated that the extent of surgical treatment in both breast and axilla can be minimized through a multimodal and personalized management, based on assessment of breast cancer (BC) molecular subtypes, genetics and on the prevailing relevance of systemic therapies. Axillary lymph-nodes dissection (ALND) represents the older surgical modality for appropriate staging and for adjuvant systemic and radiation therapies planning. Thanks to findings from extensive and crucial clinical trials, sentinel lymph node biopsy (SLNB) replaced this approach, obviating the need for ALND in node-negative disease patients, both in mastectomy and conservative surgery, and becoming a crucial turning point in BC managing. Furthermore, recent clinical trials have established that ALND can be avoided in those patients with low axillary disease burden in the sentinel nodes who are undergoing breast-conserving surgery (BCS) with radiotherapy. Several studies also proved that neoadjuvant chemotherapy (NAC) increases the BCS rates, as well reducing the extent of axillary surgery. The potential oncological safety of axillary observation choice in early BC patients undergoing BCS, in the recent perspective of the prevailing value of BC biology, is also under scientific evaluation. This study explores the current role of SLNB in BC patients eligible for BCS, providing a view into future directions in BC care.

乳腺癌保守手术前哨淋巴结活检:在临床实践中的作用变化。
最近的研究表明,基于乳腺癌(BC)分子亚型的评估、遗传学和全身治疗的普遍相关性,通过多模式和个性化的管理,可以最大限度地减少乳房和腋窝手术治疗的范围。腋窝淋巴结清扫术(ALND)代表了合适分期和辅助全身和放射治疗计划的较老的手术方式。由于广泛和重要的临床试验的发现,前哨淋巴结活检(SLNB)取代了这种方法,在淋巴结阴性疾病患者中,无论是在乳房切除术还是保守手术中,都不需要ALND,并成为BC治疗的关键转折点。此外,最近的临床试验表明,前哨淋巴结腋窝疾病负担低的患者在接受保乳手术(BCS)和放疗的情况下可以避免ALND。一些研究也证明,新辅助化疗(NAC)增加BCS率,并减少腋窝手术的范围。早期BC患者行BCS时,腋窝观察选择的潜在肿瘤学安全性,从近期BC生物学的主流价值来看,也在科学评估中。本研究探讨了SLNB在符合BCS条件的BC患者中的作用,为BC护理的未来方向提供了观点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Minerva chirurgica
Minerva chirurgica 医学-外科
CiteScore
1.40
自引率
0.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: Minerva Chirurgica publishes scientific papers on surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.
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