Abdulla Hussain, Hamza Eman, Alsendi Maha
Government Hospitals, Manama, Bahrain.
Bahrain Oncology Center, Busaiteen, Bahrain.
J Egypt Natl Canc Inst. 2025 Sep 22;37(1):60. doi: 10.1186/s43046-025-00318-7.
Landmark trials have shown that axillary lymph node dissection (ALND) can be safely omitted in early breast cancer patients with 1-2 positive nodes. Despite lack of prospective data, the National Comprehensive Cancer Network (NCCN) guidelines recommend that patients with 1-2 suspicious or biopsy-proven positive lymph nodes having primary surgery can undergo sentinel lymph node biopsy (SLNB). In the era of de-escalation of axillary surgery, breast cancer management in patients with clinically node-positive (cN +) axilla is driven by tumour biology and response to neoadjuvant chemotherapy (NACT). In this review, we discuss the management of the axilla in early breast cancer patients with low-volume biopsy-proven nodal disease and summarise the evidence supporting omission of ALND in these patients undergoing primary surgery.
具有里程碑意义的试验表明，对于腋窝淋巴结转移1-2枚阳性的早期乳腺癌患者，可以安全地省略腋窝淋巴结清扫术（ALND）。尽管缺乏前瞻性数据，但美国国立综合癌症网络（NCCN）指南建议，对于1-2枚可疑或活检证实为阳性淋巴结且接受初次手术的患者，可进行前哨淋巴结活检（SLNB）。在腋窝手术降阶梯的时代，临床腋窝淋巴结阳性（cN+）患者的乳腺癌管理取决于肿瘤生物学特性和对新辅助化疗（NACT）的反应。在本综述中，我们讨论了活检证实淋巴结转移灶数量少的早期乳腺癌患者腋窝的管理，并总结了支持这些接受初次手术的患者省略ALND的证据。
