Axillary Management: How Much Is Too Much?

Nicci Owusu-Brackett; Benjin Facer; Dionisia Quiroga; Ashley Pariser; Michael Grimm; Sasha Beyer; Sachin Jhawar; Bridget A Oppong

doi:10.1007/s11912-024-01539-0

Axillary Management: How Much Is Too Much?

Curr Oncol Rep. 2024 May 15. doi: 10.1007/s11912-024-01539-0. Online ahead of print.

Authors

Nicci Owusu-Brackett¹, Benjin Facer², Dionisia Quiroga³, Ashley Pariser³, Michael Grimm⁴, Sasha Beyer², Sachin Jhawar², Bridget A Oppong⁵

Affiliations

¹ Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA.
² Department of Radiation Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA.
³ Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA.
⁴ West Virginia University School of Medicine, Morgantown, WV, USA.
⁵ Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA. bridget.oppong@osumc.edu.

PMID: 38748364
DOI: 10.1007/s11912-024-01539-0

Abstract

Purpose of review: To review the current management of the axilla in breast cancer.

Recent findings: Axillary dissection is no longer indicated in patients with clinically node-negative axilla with 1-2 positive sentinel lymph nodes following upfront surgery or in patients with clinically node-negative axilla following neoadjuvant chemotherapy. Breast cancer has evolved away from routine axillary clearance to the less invasive sentinel lymph node biopsy to now complete omission of axillary sampling in select patients. We will review the most salient evidence that has shaped these practice changes over the last three decades. Current practice controversies are especially relevant for elderly populations and those receiving neoadjuvant therapy. Ongoing clinical trials will provide data to further guide breast cancer surgical management.

Keywords: Axilla; Breast Cancer; Neoadjuvant Systemic Therapy; Nodal Irradiation; Surgery.

Publication types

Review