Axillary Management after Neoadjuvant Chemotherapy; A Review of How and When?

Abstract

Axillary management in breast cancer has multiple paradigm changes. From standard axillary dissection level 1 and level 2 to sentinel lymph node biopsy in early-stage breast cancer. Now sentinel lymph node biopsy trend to use after neoadjuvant treatment to reduce the morbidity from standard axillary dissection. This review is collecting information on axillary management after neoadjuvant chemotherapy. Such as how to improve the accuracy of SLN in initial clinical nodal negative and initial clinical nodal positive before receiving neoadjuvant treatment, the role of axillary dissection after SLN, and the role of radiation therapy and the factors that predict the pathological nodal negative after neoadjuvant treatment. This review can support surgeons who decide to do SLN after neoadjuvant treatment.